We describe the presentation, evolution and treatment of a child with ocular toxocariasis.
A 7-year-old male presented with a two-month history of loss of vision in the left eye (LE) and an ultrasound diagnosis of retinal detachment.
Antecedents without interest and amblyopia of this eye in conservative treatment.
Complete ophthalmological study was performed: visual acuity (VA), biomicroscopy, tonus, fundus examination, ultrasound (US), fluorescein angiography (FFA), sample study for PCR and enzyme analysis
The VA was unit in RE and hand movements in LE.
Both biomycosis and ocular tension were normal.
Eye fundus showed grand malingitis, which made it difficult to assess the retina. A papillary granuloma with macular hole was observed.
The differential diagnosis was proposed with pars planitis, toxoplasmosis, toxocariasis and syndromic.
A general study was initiated that included chest X-ray, blood count, liver tests, proteinogram, and serology of loes, toxoplasma, and ELISA toxoplasma.
It was decided to start treatment with general corticosteroids (1 mg/kg/day).
ELISA was positive for toxocariasis and negative for toxoplasmosis, establishing the diagnosis of ocular toxocariasis in the form of granuloma of the posterior pole.
Once diagnosed, the patient admitted having had contact with a dog puppy in the park.
A parasitological study of fecal material was carried out and the presence of Migrans larvae was ruled out at another level.
An ocular ECHO (which was reported as normal) was also performed to rule out calcifications and an analytical test was requested in which a hypergammaglobulinemia and an absence of globulinemia were detected.
The same treatment was maintained.
One month later, VA persisted, but traction on the macula and granulomas was maintained, so peripheral resection was decided.
Macular traction and granulomas were cleaned and a vitreous sample was taken under air. PCR and ELISA were positive for Toxo cani.
The histological sample discarded cells.
VA improved to 0.3 although activity persisted in AGF.
The treatment was maintained for two weeks obtaining a VA of 0.5.
The follow-up period was 10 months, during which two small buds of anterior inflammation and one subsequent buds were treated with general corticoids maintaining VA in 0.5.
