Ocular Toxocariasis Mimicking Persistent Fetal Vasculature in a Child.

Purpose: To report a case of ocular toxocariasis in a child initially suspected to have persistent fetal vasculature (PFV), highlighting the importance of accurate differential diagnosis in cases of retrolental membranes.

Methods

A single case was reviewed.

Results

A 4-year-old Guatemalan boy presented with a 3-week history of right eye irritation and visual acuity limited to counting fingers. Clinical examination revealed a retrolental membrane extending to the optic nerve, initially suggestive of PFV. Further investigation under anesthesia revealed a visually significant funnel-shaped vitreous cavity devoid of vascularity. Fluorescein angiography showed a peripheral avascular retina with leakage, suggesting a granulomatous lesion. Pars plana vitrectomy and lensectomy revealed a chorioretinal scar in the peripheral inferonasal retina. Serologic testing confirmed the diagnosis of ocular toxocariasis, with the presence of Toxocara immunoglobulin G antibodies and peripheral eosinophilia.

Conclusions

Ocular toxocariasis can mimic PFV in pediatric patients presenting with retrolental membranes. Careful clinical evaluation, imaging, surgical exploration, and serologic testing are essential for accurate diagnosis and appropriate management.