Subretinal angiostrongyliasis-induced optic neuritis

Sinawat, Suthasinee; Yospaiboon, Yosanan; Sinawat, Supat

doi:10.2147/opth.s43565

Cited by 12 publications

(12 citation statements)

References 6 publications

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“…The route taken by A. cantonensis to enter the eye is unknown, though worms may travel from the brain via the optic nerve, through the circulation via the retinal artery, or enter the eye directly from the environment (Martins et al 2015). Worms may be found in the anterior chamber, the vitreous cavity or the subretinal space (Kumar et al 2005; Malhotra et al 2006; Sawanyawisuth et al 2007; Crane et al 2013; Sinawat and Yospaiboon, 2013; Galor and Eberhard, 2014). Clinical signs of ocular angiostrongyliasis are diverse and may include uveitis, macular oedema, retinal oedema, necrotic retinitis, panophthalmitis, papilledema, optic neuritis, optic nerve compression, orbital inflammation, increased intraocular pressure, retinal oedema, macular oedema and a pale optic disc (Kumar et al 2005; Liu et al 2006; Wang et al 2006 b ; Sawanyawisuth and Kitthaweesin, 2008; Sinawat et al 2008; Qi et al 2009; Feng et al 2013; Sinawat and Yospaiboon, 2013; Chi et al 2014).…”

Section: Pathophysiology and Clinical Manifestationsmentioning

confidence: 99%

Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen

et al. 2016

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Angiostrongylus cantonensis is a metastrongyloid nematode found widely in the Asia-Pacific region, and the aetiological agent of angiostrongyliasis; a disease characterized by eosinophilic meningitis. Rattus rats are definitive hosts of A. cantonensis, while intermediate hosts include terrestrial and aquatic molluscs. Humans are dead-end hosts that usually become infected upon ingestion of infected molluscs. A presumptive diagnosis is often made based on clinical features, a history of mollusc consumption, eosinophilic pleocytosis in cerebral spinal fluid, and advanced imaging such as computed tomography. Serological tests are available for angiostrongyliasis, though many tests are still under development. While there is no treatment consensus, therapy often includes a combination of anthelmintics and corticosteroids. Angiostrongyliasis is relatively rare, but is often associated with morbidity and sometimes mortality. Recent reports suggest the parasites' range is increasing, leading to fatalities in regions previously considered Angiostrongylus-free, and sometimes, delayed diagnosis in newly invaded regions. Increased awareness of angiostrongyliasis would facilitate rapid diagnosis and improved clinical outcomes. This paper summarizes knowledge on the parasites' life cycle, clinical aspects and epidemiology. The molecular biology of Angiostrongylus spp. is also discussed. Attention is paid to the significance of angiostrongyliasis in Australia, given the recent severe cases reported from the Sydney region.

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Section: Pathophysiology and Clinical Manifestationsmentioning

confidence: 99%

Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen

et al. 2016

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“…Murine infection with the nematode Angiostrongylus cantonesis represents an entirely different model of ON. This helminth is neuro-invasive and is capable of causing meningitis, encephalitis, and/or myelitis in humans with an eosinophilic inflammatory response [73] and is also recognized as a cause of optic neuritis in humans [74]. A. cantonesis has recently been used as an infectious trigger for ON in BALB/c mice.…”

Section: Animal Models Of Onmentioning

confidence: 99%

Optic Neuritis: A Model for the Immuno-pathogenesis of Central Nervous System Inflammatory Demyelinating Diseases

Wu¹,

Harp²,

Shindler³

2015

CIR

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Evidence for the tenuous regulation between the immune system and central nervous system (CNS) can be found with examples of interaction between these organ systems gone awry. Multiple sclerosis (MS) is the prototypical inflammatory disease of the CNS and is characterized by widely distributed inflammatory demyelinating plaques that can involve the brain, spinal cord and/or optic nerves. Optic neuritis (ON), inflammatory injury of the optic nerve that frequently occurs in patients with MS, has been the focus of intense study in part given the readily accessible nature of clinical outcome measures. Exploring the clinical and pathological features of ON in relation to other inflammatory demyelinating conditions of the CNS, namely MS and neuromyelitis optica, provides an opportunity to glean common and distinct mechanisms of disease. Emerging data from clinical studies along with various animal models involving ON implicate innate and adaptive immune responses directed at glial targets, including myelin oligodendrocyte glycoprotein and aquaporin 4. Resolution of inflammation in ON is commonly observed both clinically and experimentally, but persistent nerve injury is also one emerging hallmark of ON. One hypothesis seeking evaluation is that, in comparison to other sites targeted in MS, the optic nerve is a highly specialized target within the CNS predisposing to unique immunologic processes that generate ON. Overall, ON serves as a highly relevant entity for understanding the pathogenesis of other CNS demyelinating conditions, most notably MS.

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“…Only 1.1% of diagnosed patients develop ocular angiostrongyliasis, which is identified Angiostrongylus cantonensis in any part of the eye 1. Of 43 previous case reports, 20 cases (46.5%) originated from Thailand 2,3. Ocular findings have included lateral rectus palsy, facial palsy, glaucoma, uveitis, disk swelling, disk atrophy, retinal pigment alterations, subretinal tracks, necrotizing retinitis, and exudative retinal detachment.…”

Section: Introductionmentioning

confidence: 99%

<p>Ocular angiostrongyliasis in Thailand: a retrospective analysis over two decades</p>

Sinawat

Trisakul

Choi

et al. 2019

OPTH

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Purpose To elucidate the clinical manifestations, management, and visual outcomes of patients with ocular angiostrongyliasis. Methods This was a single-center retrospective study of patients with ocular angiostrongyliasis presenting between 1995 and 2017 at Srinagarind Hospital, Khon Kaen, Thailand. Cases were found based on a search of diagnostic codes. A total of 18 patients were diagnosed through identification of the Angiostrongylus cantonensis parasite within the eye. Medical records and ocular photography were reviewed. Results There were 18 cases, with a mean age of 40.7±14.2 years. All patients had a history of raw food ingestion, such as snails. Most of the patients presented with blurred vision: 13 cases (72.22%) had best-corrected visual acuity of 2/60 or worse. Only one living larva was detected in each case. The size of larvae varied widely from 2.6–12.6 mm in length. Larvae were commonly detected in the vitreous cavity. Although multiple treatment modalities were used, including focal laser, surgery, antihelminthic drugs, and steroid treatment, the majority of cases (70.6%) did not have visual improvement. Conclusion Focal laser is recommended to eradicate subretinal angiostrongyliasis, while laser treatment prior to surgical removal is recommended to eliminate intracameral and intravitreal angiostrongyliasis. Pulse methylprednisolone therapy may be beneficial in cases of acute optic neuritis. The visual prognosis mainly depends on ocular pathology and parasitic migration pathway.

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Subretinal angiostrongyliasis-induced optic neuritis

Cited by 12 publications

References 6 publications

Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen

Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen

Optic Neuritis: A Model for the Immuno-pathogenesis of Central Nervous System Inflammatory Demyelinating Diseases

<p>Ocular angiostrongyliasis in Thailand: a retrospective analysis over two decades</p>

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