T J Stokkermans1. 1. Bascom Palmer Eye Institute, Miami, Florida, USA. stokkerman@aol.com
Abstract
BACKGROUND: Diffuse unilateral subacute neuroretinitis (DUSN) is an inflammatory disorder of the retina thought to be caused by a motile worm. It initially presents with unilateral recurring crops of gray-white retinal lesions and mild to severe inflammation. Over a period of months, diffuse retinal pigment epithelium (RPE) changes, arteriolar attenuation, and optic atrophy will develop. In approximately 25% of cases, a worm is visualized during the eye examination. Laser treatment to kill the worm is the only reliable way to halt progression of this disease. METHODS: The following case report presents a 9-year-old girl with unilateral vision loss. RESULTS: Clinical observation and several blood tests to rule out systemic diseases resulted in a diagnosis of DUSN. Although a worm was not visualized, laser treatment of its suspected location resulted in recovery of some vision. CONCLUSIONS: DUSN is often diagnosed by clinical presentation alone, because a worm may not be visualized. An appropriate initial work-up and timely initiation of laser treatment are essential to preservation of vision.
BACKGROUND: Diffuse unilateral subacute neuroretinitis (DUSN) is an inflammatory disorder of the retina thought to be caused by a motile worm. It initially presents with unilateral recurring crops of gray-white retinal lesions and mild to severe inflammation. Over a period of months, diffuse retinal pigment epithelium (RPE) changes, arteriolar attenuation, and optic atrophy will develop. In approximately 25% of cases, a worm is visualized during the eye examination. Laser treatment to kill the worm is the only reliable way to halt progression of this disease. METHODS: The following case report presents a 9-year-old girl with unilateral vision loss. RESULTS: Clinical observation and several blood tests to rule out systemic diseases resulted in a diagnosis of DUSN. Although a worm was not visualized, laser treatment of its suspected location resulted in recovery of some vision. CONCLUSIONS:DUSN is often diagnosed by clinical presentation alone, because a worm may not be visualized. An appropriate initial work-up and timely initiation of laser treatment are essential to preservation of vision.
Authors: Ng Guan-Fook; Abd Aziz Hayati; Mohd Noor Raja-Azmi; Ahmad Tajudin Liza-Sharmini; Wan Hitam Wan-Hazabbah; Embong Zunaina Journal: Clin Ophthalmol Date: 2012-03-27