Diffuse Unilateral Subretinal Neuroretinitis

A 54-year-old woman from Honduras with a history of T2DM, HTN, OSA presented with 4 months of progressive visual loss in the right eye. She had been seen by many eye care providers and carried the diagnoses of macular degeneration and multifocal choroiditis. At presentation, her vision in the right eye was hand motion, 20/25 in the left. Exam revealed an rAPD on the right. Exam was significant for unilateral optic atrophy, numerous yellow chorioretinal scars in the macula and posterior pole. A live, motile, intravitreal worm was identified in the posterior pole. Due to the presence of a worm, laser photocoagulation was attempted to destroy the worm. The motile worm was unaffected by laser. Pars plana vitrectomy was performed and the intravitreal worm was recovered. The patient was treated with high-dose albendazole 200mg BID for 21 days and seen by infectious disease specialist. Her vision remained count fingers at 3 feet at follow up. We report the first case of DUSN with identified intravitreal worm successfully removed with PPV.  

Presentation Date: 12/12/2019

Issue Date: 08/01/2020