Xu Qing , Gong Chaoju , Yang Xiao , Liu Yalu , Li Jie , Sheng Aiqin , Zhang Yipeng , Qiao Lei , Li Yanlian , Li Suyan
  • Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou Eye Disease Prevention and Treatment Institute, Xuzhou 221116, China;
Li Suyan, Email: lisuyan1226@126.com
Ocular Toxocariasis; Anti-toxocara immunoglobulin G; Serum; Diagnostic value
10.3760/cma.j.cn511434-20240104-00002
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Objective To assess the diagnostic performance of serum anti-Toxocara immunoglobulin G (anti-T-IgG) in ocular toxocariasis (OT) patients. Methods A diagnostic tests. A total of 109 patients (109 eyes) with clinically-suspected OT who treated in Xuzhou First People’s Hospital from June 2015 to December 2022 were included. Patients were divided into two groups, 76 with OT and 33 with non-OT, according to the clinical manifestations and Goldmann-Witmer coefficient. Paired serum and intraocular fluid samples from each patient were collected and analyzed for specific anti-T-IgG using enzyme linked immunosorbent assay. Mann-Whitney test was performed for comparison between groups. The area under the receiver operating characteristic curve (ROC) was used to assess the diagnostic performance of serum anti-T-IgG. Kappa analysis was performed to examine the consistency of serum or intraocular fluid anti-T-IgG positive rate with OT diagnostic result. Spearman’s rank correlation test was performed to assess the association. Results Compared with the non-OT group, the proportions of children and history of exposure to cats and dogs (χ2=9.785, 12.026) were significantly higher in OT group, and the differences were statistically significant (P＜0.01). The positive rate (χ2=24.551) and U value (Z=−4.379) of serum anti-T-IgG in OT group were higher than those in non-OT group, and the differences were statistically significant (P＜0.000 1). The recommended serum anti-T-IgG cut-off value of 11 U had 0.72 sensitivity, 0.79 specificity, 0.89 positive predictive value, 0.55 negative predictive value, and 0.77 area under the ROC with 95% confidence interval (CI) 0.669-0.860. Correlation analysis showed that serum anti-T-IgG was positively correlated with intraocular fluid anti-T-IgG (rs=0.520, P＜0.0001, 95% CI 0.363-0.648). The Kappa values of serum and intraocular fluid anti-T-IgG positive rate with OT diagnosis were 0.457 (95% CI 0.292-0.622) and 0.711 (95% CI 0.582-0.840), respectively. The Kappa value of serum anti-T-IgG positive rate with OT diagnosis was lower than that of intraocular fluid. Conclusion The sensitivity and specificity of serum anti-T-IgG and the consistency between serum anti-T-IgG positive rate and OT diagnosis are low, suggesting that serum anti-T-IgG level cannot be used as a basis for OT diagnosis.