OCULAR CHANGES ASSOCIATED WITH GIARDIA-LAMBLIA INFECTION IN CHILDREN

Background-The protozoan disease giardiasis can cause ocular complicat ions, including ''salt and pepper'' retinal changes. Methods-Ophthalmi c examinations were performed in 141 children (mean age 4.7 (SD 2.0) y ears) with active or past giardiasis diagnosed on the basis of microsc opic examination of stool specimens or duodenal secretions-53 were new ly diagnosed and untreated (group A), 50 had active infections in spit e of metronidazole therapy (group B), and 38 had been successfully tre ated, with negative stool specimens for 1-3 years (group C). 300 child ren with no evidence of giardiasis were used as controls. Results-Salt and pepper retinal changes (with normal electroretinographic findings ) were diagnosed in 28 (19.9%) of the patients with giardiasis (11 fro m group A, 10 from group B, and seven from group C), including five pa irs of siblings. In all subgroups, the children with retinal changes w ere consistently younger than those with normal retinas. In eight case s, the lesions could be visualised only with direct ophthalmoscopy. Co nclusion-Our findings indicate that asymptomatic, non-progressive reti nal lesions are particularly common in younger children with giardiasi s. This risk does not seem to be related to the severity of the infect ion, its duration, or the use of metronidazole but may reflect a genet ic predisposition.