Video:Ocular larva migrans
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Description
Ocular larva migrans also known as ocular toxocariasis, is the ocular form of larva migrans syndrome. It occurs when roundworm larvae invade the human eye. OLM infections in humans are caused by the larvae of Toxocara canis , Toxocara cati , Ascaris suum , or Baylisascaris procyonis .[1][2][3]They may be associated with visceral larva migrans. Unilateral visual disturbances, strabismus, and eye pain are the most common presenting symptoms.Blood tests to detect antibodies against Toxocara are used for diagnosis.Treatment can consist of antiparasitic medications(albendazole, mebendazole).[2][1][4]
Presentation
As to the presentation of Ocular larva migrans we find the following:[5] unilateral vision loss, eye pain and floaters.
Complications
As to the complications eye involvement can cause we find the following inflammatory disorders:[1]Angle-closure glaucoma, Cystoid macular edema and Macular degeneration.
Cause
In terms of etiology, Ocular larva migrans is primarily caused by the species Toxocara canis, which is the most common cause, though there are others.[1][2]
Mechanism
Ocular toxocariasis begins when humans ingest Toxocara eggs which then hatch in the intestine. These larvae penetrate the intestinal wall, enter the bloodstream, and migrate throughout the body eventually lodging in eye. In the eye the larva and its secreted antigens trigger a localized granulomatous inflammatory response from the immune system, which attempts to wall off the parasite. This inflammation leads to the formation of a mass on the retina, and results in associated complications - chronic inflammation, fibrosis, and tractional retinal detachment which are mechanisms that cause permanent vision loss.[1][6][7]
Diagnosis
The disease presents with an eosinophilic granulomatous mass, most commonly in the posterior pole of the retina. The granulomatous mass develops around the entrapped larva, in an attempt to contain the spread of the larva.ELISA testing of intraocular fluids has been demonstrated to be of great value in diagnosing ocular toxocariasis.[1][2]
Differential diagnosis
In terms of the differential diagnosis for Ocular larva migrans we find the following :[1] Panuveitis, Coats disease, Familial exudative vitreoretinopathy, Retinal pigment epithelium, SHAPU, Retinoblastoma, Endophthalmitis and Retinopathy of prematurity.
Management
As to treatment we find that the following is done in the affected individual:[1][2] Anti-helminthic therapy(Albendazole) , corticosteroids(topically, periocularly, intraocularly, or systemically), laser photocoagulation and surgery.
Prognosis
As to the outlook we find that individuals who receive treatment early have a good prognosis; however individuals presenting late do not have as favorable a prognosis for different reasons including retinal detachment.[1]
Epidemiology
Although systemic toxocariasis is common worldwide,with seroprevalence ranging from 4 to 31 percent in developed countries and up to 80 percent in tropical regions,ocular involvement is much less frequent, often underdiagnosed/misclassified as retinoblastoma.[8][2]
History
As to history we find that Ocular Larva Migrans was first described by Wilder in 1950.She published a report on the ocular infection, identifying a nematode larva within retinal granulomas in enucleated eye specimens.[1]
Society and culture
In terms of socioeconomic link we find studies consistently show a higher prevalence of Toxocara infection in low-socioeconomic groups. Seroprevalence has been found to be significantly higher among those living below the poverty line.[9][10]
Research
A July 2025 study found that measuring intraocular fluid total IgE and the IF/serum IgE ratio improves diagnostic accuracy for ocular toxocariasis, especially in children who showed notably higher intraocular IgE levels than adults; this may indicate age-related immune differences. [11]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 Gupta, Abhishek; Tripathy, Koushik (2025). "Ocular Toxocariasis". StatPearls. StatPearls Publishing. PMID 35015409. Archived from the original on 2024-04-30. Retrieved 2025-10-31.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 "Ocular Toxocariasis - Europe". American Academy of Ophthalmology. 13 October 2014.
- ↑ Klintworth, Gordon K.; Garner, Alec (1 November 2007). Garner and Klintworth's Pathobiology of Ocular Disease (Part A). CRC Press. ISBN 978-1-040-20978-3.Google books does not offer page
- ↑ Arevalo, J. Fernando; Espinoza, Juan V.; Arevalo, Fernando A. (March 2013). "Ocular Toxocariasis". Journal of Pediatric Ophthalmology & Strabismus. 50 (2): 76–86. doi:10.3928/01913913-20120821-01. PMID 22938514. Retrieved 18 November 2025.
- ↑ "Toxocariasis - EyeWiki". eyewiki.org. Archived from the original on 11 October 2025. Retrieved 31 October 2025.
- ↑ Fernando, Ranjan L.; Fernando, Sujatha S. E.; Leong, Anthony Siew-Yin (2 January 2001). Tropical Infectious Diseases: Epidemiology, Investigation, Diagnosis and Management. Cambridge University Press. p. 100. ISBN 978-1-900151-39-9.
- ↑ Greigert, Valentin; Bittich-Fahmi, Faiza; Pfaff, Alexander W. (31 December 2020). "Pathophysiology of ocular toxoplasmosis: Facts and open questions". PLOS Neglected Tropical Diseases. 14 (12): e0008905. doi:10.1371/journal.pntd.0008905. ISSN 1935-2735. PMC 7774838. PMID 33382688.
- ↑ "Ocular Toxocariasis - Asia Pacific". American Academy of Ophthalmology. 13 October 2014. Retrieved 13 November 2025.
- ↑ Chen, Jia; Liu, Quan; Liu, Guo-Hua; Zheng, Wen-Bin; Hong, Sung-Jong; Sugiyama, Hiromu; Zhu, Xing-Quan; Elsheikha, Hany M. (13 June 2018). "Toxocariasis: a silent threat with a progressive public health impact". Infectious Diseases of Poverty. 7 (1): 59. doi:10.1186/s40249-018-0437-0. ISSN 2049-9957. Archived from the original on 19 September 2025. Retrieved 22 November 2025.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ↑ Hare, Anna Quinn; Franco-Paredes, Carlos (1 March 2014). "Ocular Larva Migrans: A Severe Manifestation of an Unseen Epidemic". Current Tropical Medicine Reports. 1 (1): 69–73. doi:10.1007/s40475-013-0004-5. ISSN 2196-3045. Retrieved 22 November 2025.
- ↑ Zhang, Shuang; Chen, Li; Hu, Xiaofeng; Wang, Hui; Feng, Jing; Tao, Yong (28 July 2025). "Evaluation of the intraocular total IgE level and its ratio with serum IgE level for the diagnosis of ocular toxocariasis in children and adults: a retrospective comparative study". BMC Ophthalmology. 25 (1): 428. doi:10.1186/s12886-025-04252-z. ISSN 1471-2415. PMID 40721731.