To the Editor.
—Dr. Bresnick is justified in demanding "stringent histological criteria" in the diagnosis of toxocara infection. The clinicopathological case report was typical of previously described cases of chronic endophthalmitis due to toxocara.1 The eye demonstrated a detached and disorganized retina, subretinal exudate, chronic uveal inflammation containing numerous eosinophils, and a large well-defined peripheral granuloma composed of chronic inflammatory and epithelioid cells in a connective tissue matrix. Figure 3 of the article identified and labeled correctly a subretinal tract, 2 mm in diameter, which had been followed through 59 of 123 serial sections of the eye and connected the peripheral granuloma with the optic disc. Dr. Bresnick apparently mistook the photograph of the tract for that of the granuloma.The similarity between Coats disease and toxocara infection is well established in the ophthalmic literature. Many of the specimens in Wilder's2 classical description of nematode endophthalmitis had
O'Connor PR. Visceral Larva Migrans-Reply. Arch Ophthalmol. 1973;89(5):440. doi:10.1001/archopht.1973.01000040442023
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