Diffuse unilateral subacute neuroretinitis with unusual findings

Area of Science:

• Ophthalmology
• Infectious Diseases
• Parasitology

Background:

• Diffuse unilateral subacute neuroretinitis (DUSN) is an inflammatory condition affecting the optic nerve and retina.
• Etiology is often attributed to nematode parasites, but causative agents can vary.
• Unusual presentations of DUSN warrant detailed investigation and reporting.

Observation:

• Two cases of DUSN were identified with distinct, uncommon clinical features.
• One patient presented with a large, live intraocular worm, a finding significantly larger than typically reported.
• The second patient exhibited a macular cyst associated with DUSN, an infrequently observed complication.

Findings:

• Diagnostic imaging, including fundus fluorescein angiography and optical coherence tomography, was utilized in both cases.
• Treatment involved targeted photocoagulation for the worm in one patient and oral albendazole for the other.
• Both patients demonstrated clinical stability over a six-month follow-up period, indicating successful management.

Implications:

• The large worm suggests potential novel or less common causative agents for DUSN.
• Macular cyst formation represents an additional potential sequela of DUSN.
• These findings expand the known clinical spectrum of DUSN and inform diagnostic and therapeutic strategies.