Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children
PurposeThis article aims to report a case of successful treatment of peripheral granulomatous ocular toxocariasis (OT) in an 8-year-old patient using intravitreal injection of dexamethasone (DEX) implant (Ozurdex) under ultrasound biomicroscopy (UBM) guidance.Case presentationA previously healthy 8-...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1176585/full |
| _version_ | 1797826259944734720 |
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| author | Xin Zhang Xinzhu Hou Yan Zhang Jingjie Liu Zhiyong Zhang Zhiyong Zhang |
| author_facet | Xin Zhang Xinzhu Hou Yan Zhang Jingjie Liu Zhiyong Zhang Zhiyong Zhang |
| author_sort | Xin Zhang |
| collection | DOAJ |
| description | PurposeThis article aims to report a case of successful treatment of peripheral granulomatous ocular toxocariasis (OT) in an 8-year-old patient using intravitreal injection of dexamethasone (DEX) implant (Ozurdex) under ultrasound biomicroscopy (UBM) guidance.Case presentationA previously healthy 8-year-old boy with a history of long-term close contact with dogs complained of blurring of vision in the right eye for a year. Ophthalmic examination of his right eye showed chronic uveitis. Notably, UBM examination identified granulomas and peripheral vitreous strand in the ciliary body from 3 to 8 o'clock positions. Enzyme-linked immunosorbent assay (ELISA) results of the intraocular fluid (IF) and serum showed increased anti-Toxocara immunoglobulin G (IgG) levels, leading to a diagnosis of peripheral granulomatous OT in the right eye. Intraocular surgery was not indicated in this case. The treatment goal was to alleviate uveitis, improve visual acuity, and prevent complications. He was treated with an intravitreal injection of DEX implant, administered as a single dose every three months, total two doses, combined with albendazole, an oral anthelmintic. Under preoperative UBM guidance, two injections were performed at the 12 and 10 o'clock positions in the pars plana where there were no granulomas and peripheral vitreous strand, successfully preventing complications associated with intravitreal injection. After two injections, the patient's right eye vision improved significantly, with the best-corrected visual acuity (BCVA) increasing from 20/400 to 20/50. Vitreous opacity and retinal edema were reduced, preretinal proliferative membrane was stabilized, and no adverse events occurred.ConclusionUBM can accurately determine the location and extent of peripheral granulomas in OT patients, facilitating the avoidance of granulomas during intravitreal injection and preventing complications associated with intravitreal injection. Under the close follow-up and strict adherence to indications, preoperative UBM-guided intravitreal injections of DEX implant treatment for pediatric peripheral granulomatous OT are safe and effective, providing a new therapeutic option for pediatric peripheral granulomatous OT. |
| first_indexed | 2024-03-13T11:06:07Z |
| format | Article |
| id | doaj.art-10230b0f3ce04901b640adf3de58e747 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T11:06:07Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-10230b0f3ce04901b640adf3de58e7472023-05-16T05:38:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-05-011010.3389/fmed.2023.11765851176585Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in childrenXin Zhang0Xinzhu Hou1Yan Zhang2Jingjie Liu3Zhiyong Zhang4Zhiyong Zhang5The Second School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaThe Second School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaThe Second School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaThe Second School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaThe Second School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaEye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, ChinaPurposeThis article aims to report a case of successful treatment of peripheral granulomatous ocular toxocariasis (OT) in an 8-year-old patient using intravitreal injection of dexamethasone (DEX) implant (Ozurdex) under ultrasound biomicroscopy (UBM) guidance.Case presentationA previously healthy 8-year-old boy with a history of long-term close contact with dogs complained of blurring of vision in the right eye for a year. Ophthalmic examination of his right eye showed chronic uveitis. Notably, UBM examination identified granulomas and peripheral vitreous strand in the ciliary body from 3 to 8 o'clock positions. Enzyme-linked immunosorbent assay (ELISA) results of the intraocular fluid (IF) and serum showed increased anti-Toxocara immunoglobulin G (IgG) levels, leading to a diagnosis of peripheral granulomatous OT in the right eye. Intraocular surgery was not indicated in this case. The treatment goal was to alleviate uveitis, improve visual acuity, and prevent complications. He was treated with an intravitreal injection of DEX implant, administered as a single dose every three months, total two doses, combined with albendazole, an oral anthelmintic. Under preoperative UBM guidance, two injections were performed at the 12 and 10 o'clock positions in the pars plana where there were no granulomas and peripheral vitreous strand, successfully preventing complications associated with intravitreal injection. After two injections, the patient's right eye vision improved significantly, with the best-corrected visual acuity (BCVA) increasing from 20/400 to 20/50. Vitreous opacity and retinal edema were reduced, preretinal proliferative membrane was stabilized, and no adverse events occurred.ConclusionUBM can accurately determine the location and extent of peripheral granulomas in OT patients, facilitating the avoidance of granulomas during intravitreal injection and preventing complications associated with intravitreal injection. Under the close follow-up and strict adherence to indications, preoperative UBM-guided intravitreal injections of DEX implant treatment for pediatric peripheral granulomatous OT are safe and effective, providing a new therapeutic option for pediatric peripheral granulomatous OT.https://www.frontiersin.org/articles/10.3389/fmed.2023.1176585/fullultrasound biomicroscopicperipheral granulomatous ocular toxocariasispediatric uveitisdexamethasone implantOzurdexintravitreal injection |
| spellingShingle | Xin Zhang Xinzhu Hou Yan Zhang Jingjie Liu Zhiyong Zhang Zhiyong Zhang Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children Frontiers in Medicine ultrasound biomicroscopic peripheral granulomatous ocular toxocariasis pediatric uveitis dexamethasone implant Ozurdex intravitreal injection |
| title | Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children |
| title_full | Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children |
| title_fullStr | Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children |
| title_full_unstemmed | Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children |
| title_short | Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children |
| title_sort | case report ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant ozurdex for peripheral granulomatous ocular toxocariasis in children |
| topic | ultrasound biomicroscopic peripheral granulomatous ocular toxocariasis pediatric uveitis dexamethasone implant Ozurdex intravitreal injection |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1176585/full |
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