ABSTRACT
A case of intraocular myasis is here reported, as well as the difficulties of diagnosis--mostly too late--of this disease, which is rare in Europe and the northern hemisphere and which leads, almost invariably, to functional or even anatomical loss of the eye.--The determination of IgE in human aqueous humor (ah) and corresponding serum (s) by means of the ultrasensitive and quite simple PRIST method could represent a possibility of timely diagnosis, and this theoretically too in the case of other, much more frequent oculoparasitosis cases.--A retrospective study of the preoperative aqueous humor of the ophthalmomyiasis case presented here revealed an IgE concentration of 113 U/ml in the aqueous humor, with only 3 U/ml (1 U congruent to 2 ng) in the corresponding serum. A simple serum-IgES-determination would not have permitted the diagnosis--at least not in the case examined--just as little as numeration of eosinophilic granulocytes in blood and/or aqueous humor.
Subject(s)
Aqueous Humor/immunology , Eye Diseases/diagnosis , Immunoglobulin E/analysis , Myiasis/diagnosis , Child, Preschool , Female , Humans , Radioimmunosorbent TestABSTRACT
The analysis of IgE in aqueous humor yielded an average concentration of 3.4 +/- 0.97 U/ml for 22 cataract patients and 5.5 +/- 3.42 U/ml for five uveitis patients. The IgE level in aqueous humor (IgEa.h.) of the cases examined is most probably, beside hematoocular diffusion of serum IgEs, the result of intra-ocular IgE production. In comparison with (mostly normal) IgEs levels, the IgEa.h. concentration appears relatively elevated, not only with uveitis patients, but also with cataract patients, above all when lenticular opacity is accompanied by other ophthalmic diseases (glaucoma, high myopia, diabetes). This "increase" of IgEa.h. concentration in very probably due to the radioimmunosorbent (RIST) technique employed, the most sensitive method available at the time of the present study. Thus, the calculated IgEa.h. value in the cataractous eyes should be regarded simply as approximate to the normal IgEa.h. concentration. These values are of clinical significance however, since a reference IgEa.h. mean-value is indispensable to the interpretation of pathologically high IgEa.h. levels and ethics do not permit of IgEa.h. determination in healthy eyes. The mean IgEa.h. levels of the delayed-type uveitis and cataract patients examined reveal no significant differences. IgEa.h. determination could make a contribution to the etiological clarification of, for example, immediate-type uveitis cases and intra-ocular parasitosis and serve as an appropriate model to study intra-ocular immunomechanisms.
