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Case Reports
. 2012 Mar;50(1):73-8.
doi: 10.3347/kjp.2012.50.1.73. Epub 2012 Mar 6.

Imported intraocular gnathostomiasis with subretinal tracks confirmed by western blot assay

Ji Ho Yang  1 , Moosang Kim, Eung Suk Kim, Byoung-Kuk Na, Seung-Young Yu, Hyung-Woo Kwak
Affiliations
Case Reports

Imported intraocular gnathostomiasis with subretinal tracks confirmed by western blot assay

Ji Ho Yang et al. Korean J Parasitol. 2012 Mar.

Abstract

We report a case of intraocular gnathostomiasis diagnosed by western blot assay in a patient with subretinal tracks. A 15-year-old male patient complained of blurred vision in the right eye, lasting for 2 weeks. Eight months earlier, he had traveled to Vietnam for 1 week and ate raw wild boar meat and lobster. His best-corrected visual acuity was 20/20 in both eyes and anterior chamber examination revealed no abnormalities. Fundus examination showed subretinal tracks in the right eye. Fluorescein angiography and indocyanine green angiography showed linear hyperfluorescence of the subretinal lesion observed on fundus in the right eye. Ultrasound examination revealed no abnormalities. Blood tests indicated mild eosinophilia (7.5%), and there was no abnormality found by systemic examinations. Two years later, the patient visited our department again for ophthalmologic evaluation. Visual acuity remained 20/20 in both eyes and the subretinal tracks in the right eye had not changed since the previous examination. Serologic examination was performed to provide a more accurate diagnosis, and the patient's serum reacted strongly to the Gnathostoma nipponicum antigen by western blot assay, which led to a diagnosis of intraocular gnathostomiasis. This is the first reported case of intraocular gnathostomiasis with subretinal tracks confirmed serologically using western blot in Korea.

Keywords: Gnathostoma; intraocular gnathostomiasis; subretinal tracks; western blot assay.

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Figures

Fig. 1
Fig. 1
Fundus photographs of both eyes of the patient, fluorescein angiography (FAG), and indocyanine green angiography (ICGA) of the patient's right eye at presentation. (A) Fundus photographs of the right eye showed criss-crossing subretinal migratory and hypopigmented tracks and multiple pigmented lesions in all quadrants at presentation. (B) Fundus photographs of the left eye showed no abnormal finding. (C) Fluorescein angiography of the right eye showed diffuse crisscrossing hyperfluorescence. (D) Indocyanine green angiography of the right eye showed diffuse crisscrossing hyperfluorescence and engorgement of some choroidal vessels.
Fig. 2
Fig. 2
Fundus photograph and optical coherence tomography (OCT) 2 years after the initial presentation (A) Photograph of the right eye showed crisscrossing subretinal migratory and hypopigmented tracks (arrow) and multiple pigmented lesions in all quadrants. (B) Optical coherence tomography of the right eye showed subretinal tracks (arrowhead) between the retinal pigment epithelium and inner segment/outer segment of the photoreceptors.
Fig. 3
Fig. 3
Immunoblot pattern showing antibodies reactive to Gnathostoma nipponicum somatic antigen. (A) Positive control serum from a patient with proven gnathostomiasis, (B) Sample 1 (1:50 diluted serum) (C) Normal control serum. The arrowheads indicate the specific immunoreactive bands.
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