眼トキソカラ症の35症例

Thirty-five cases of ocular toxocariasis

　過去11年間に，ぶどう膜炎または視神経炎などで眼トキソカラ症を疑われた356症例を検査した。35症例が免疫血清学的な5項目のうち4項目以上に陽性を示し，眼トキソカラ症と診断された。男26例，女9例であり，全例が片眼発症であった。32例（91％）が20歳以上であった。滲出性ないし隆起性の網脈絡膜病変が33眼にあり，後極部にあるもの11眼，周辺部にあるもの16眼であり，双方にあるもの6眼であった。視神経乳頭の浮腫または発赤が8眼にあった。うち7眼では滲出性ないし隆起性の網脈絡膜病変があった。牽引性網膜剥離が4眼にあった。以上の所見は海外で報告されたものとは大きく異なり，眼トキソカラ症の分類の修正が必要であると判断された。

We tested 356 patients with uveitis and/or papilledema for anti- toxocaral antibody during the foregoimg 11-year period. A total of 35 patients (26 males and 9 females) were positive for four out of five immunoserologic tests for Toxocara canis and were diagnosed as ocular toxocariasis. Only unilateral eyes were involved throughout the series. Thirty-two patients (91%) were aged 20 years or older. Exudative and/or massive chorioretinal lesions were present in 33 patients. The lesions were located in the peripheral fundus in 16 eyes, in the posterior fundus in 11 and in both areas in 6. Optic nerve lesions simulating optic neuritis was present in 8 eyes, of which 7 eyes had chorioretinal lesions. Tractional retinal detachment was present in 4 eyes. These findings were essentially different from cases reported outside Japan, suggesting the need for revised classification of ocular toxocariasis.