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Diffuse unilateral subacute neuroretinitis in a young boy: a case report
Ng Guan-Fook1, Abd Aziz Hayati, Mohd Noor Raja-Azmi
1Department of Ophthalmology, School of Medical Science, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Clinical Ophthalmology (Auckland, N.Z.)
|April 27, 2012
Summary
This case study highlights diffuse unilateral subacute neuroretinitis in a child, diagnosed via clinical signs and Toxocara immunoglobulin G detection. Treatment with albendazole and prednisolone reduced inflammation but did not restore vision.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Parasitology
Background:
- Diffuse unilateral subacute neuroretinitis (DUSN) is a rare inflammatory eye condition.
- Toxocara infection is a known, albeit uncommon, cause of neuroretinitis.
Observation:
- An 11-year-old boy presented with a year of progressive vision loss, floaters, and reduced visual acuity in his left eye.
- Clinical examination revealed a relative afferent pupillary defect, impaired color vision, vitritis, retinal pigmentary changes, optic disc edema, and subretinal lesions.
- Laboratory tests confirmed eosinophilia and detected Toxocara immunoglobulin G via Western blot, ruling out other causes.
Findings:
- The patient was diagnosed with diffuse unilateral subacute neuroretinitis secondary to Toxocara infection.
- Treatment with oral albendazole and oral prednisolone led to reduced inflammation and resolution of subretinal lesions within one month.
- Despite treatment, there was no improvement in the patient's visual acuity.
Implications:
- This case underscores the importance of considering Toxocara infection in the differential diagnosis of neuroretinitis, even without direct visualization of the parasite.
- Early diagnosis and treatment can help manage ocular inflammation, though visual prognosis may remain guarded.
- Further research into the long-term visual outcomes and optimal management strategies for Toxocara-induced neuroretinitis is warranted.
