Clinical Features of 121 Patients With Diffuse Unilateral Subacute Neuroretinitis

Filho, Carlos Alexandre de Amorim Garcia; Gomes, Alexandre Henrique Bezerra; Soares, Ana Claudia M. de A. Garcia; Garcia, Carlos Alexandre de Amorim

doi:10.1016/j.ajo.2011.09.015

Cited by 44 publications

(39 citation statements)

References 8 publications

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“…Diffuse pigment epithelial changes are suggested by some authors, to be related to a toxic reaction. Less frequent findings include iridocyclitis, subretinal hemorrhages, perivenous exudation, macular cysts, local retinal detachments, and subretinal neovascularization [1,5,16].…”

Section: Early Stagementioning

confidence: 99%

“…The subretinal worm is found in less than half of the cases, and most patients are under 20 years of age with already severe visual impairment, due to presenting in the later stages of the disease, where the likelihood of improvement is low, despite therapy. In cases of early diagnosis, prompt treatment, whether with oral antihelminthic or direct photocoagulation of the worm, patients may show good visual improvement and have a more favorable prognosis [3,[15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Diffuse unilateral subacute neuroretinitis: review article

Mazzeo

Motta

Curi

2019

J Ophthal Inflamm Infect

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Diffuse unilateral subacute neuroretinitis (DUSN) is an ocular infectious disease that can lead to severe visual impairment and blindness. It usually occurs in healthy young individuals and depending on the stage of the disease, it may present as vitritis, multifocal gray-white lesions in the outer retina, and derangement of the retinal pigment epithelium, narrowing of the retinal vessels and optic atrophy. Parasites of different sizes and species have been proposed as the etiologic agent of DUSN, including Ancylostoma caninum, Toxocara canis, and others. Thus, it is hypothesized that different infectious worms may be considered as the likely cause of both an autoimmune and toxic form of nematode retinopathy. Because serologic testing is variable, the definitive diagnosis is made when clinical characteristics of DUSN are found in conjunction with an intraocular worm. Ancillary tests can assist in the differential diagnosis when the nematode cannot be visualized, such as fluorescein and indocyanine green angiography, electrophysiological tests, visual field studies, and more recently, optical coherence tomography angiography. Cases in which the worm can be identified, it is defined as confirmed DUSN, and eyes with the typical clinical features but without identification of the worm should be classified as presumed DUSN. In confirmed DUSN, the classic treatment is directly photocoagulation of the worm; however, it can only be visualized in 30% (to 40%) of cases. Treatment of presumed DUSN cases with high-dose oral albendazole has shown encouraging results. However, perhaps due to the disease's rarity or its underdiagnosis, there are no studies comparing current treatment modalities in both presumed and confirmed DUSN. Due to the possibility of this disease being, in part, autoimmune nematode retinopathy, corticosteroids associated with both albendazole or laser therapy, could be in any way beneficial. Thus, further comparative studies are necessary to elucidate the best treatment for this potentially blinding disease.

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Section: Early Stagementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diffuse unilateral subacute neuroretinitis: review article

Mazzeo

Motta

Curi

2019

J Ophthal Inflamm Infect

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“…These are suggestive of larva migration in the sub-retinal space [6]. The worm can be located at any stage of the disease [7].…”

Section: Discussionmentioning

confidence: 99%

Diffuse Unilateral Subacute Neuroretinitis Associated with Cutaneous Larva Migrans

Sood¹,

Pathengay²,

Ac³

2017

J Clin Exp Ophthalmol

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A seven year old girl presented with history of diminished vision in her left eye. The detailed examination of the right eye was unremarkable. The anterior segment of the involved eye was unremarkable with the supero-temporal retina showing outer retinal yellow-white lesions associated with pigmentary changes. The child had itchy scaly lesions over the right sole. A diagnosis of diffuse unilateral subacute neuro-retinitis with cutaneous larva migrans was made. The retinal lesions were subjected to laser photo coagulation and systemic single dose of ivermectin was administered. There was no recurrence of the retinal lesions and the foot lesions healed. The present case highlights the importance of examination of the extremities and the role of single dose of ivermectin in the management of DUSN with cutaneous larva migrans.

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“…Optic disc involvement may be seen in the early stage of the disease, with optic disc edema associated with evanescent, multifocal, yellow-white chorioretinal lesions 250,251. The late stage is characterized by profound visual loss, with optic disc atrophy, retinal vessel narrowing, and focal or diffuse retinal pigment epithelium degeneration 250,251. Treatment options include laser therapy when the nematode is visible and chemotherapy with anthelmintic drugs, such as mebendazole, thiabendazole, or albendazole when a worm cannot be visualized 252.…”

Section: Parasitic Optic Neuropathiesmentioning

confidence: 99%

Infectious optic neuropathies: a clinical update

Kahloun¹,

Abroug²,

Ksiaa³

et al. 2015

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Different forms of optic neuropathy causing visual impairment of varying severity have been reported in association with a wide variety of infectious agents. Proper clinical diagnosis of any of these infectious conditions is based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular findings. Diagnosis is confirmed by serologic testing and polymerase chain reaction in selected cases. Treatment of infectious optic neuropathies involves the use of specific anti-infectious drugs and corticosteroids to suppress the associated inflammatory reaction. The visual prognosis is generally good, but persistent severe vision loss with optic atrophy can occur. This review presents optic neuropathies caused by specific viral, bacterial, parasitic, and fungal diseases.

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Clinical Features of 121 Patients With Diffuse Unilateral Subacute Neuroretinitis

Cited by 44 publications

References 8 publications

Diffuse unilateral subacute neuroretinitis: review article

Diffuse unilateral subacute neuroretinitis: review article

Diffuse Unilateral Subacute Neuroretinitis Associated with Cutaneous Larva Migrans

Infectious optic neuropathies: a clinical update

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