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Diffuse unilateral subacute neuroretinitis: review article.

Thiago José Muniz Machado Mazzeo¹, Mario Martins Dos Santos Motta², André Luiz Land Curi³

¹Ophthalmology Residency Program, Federal University of the State of Rio de Janeiro (UNIRIO), Gaffrée and Guinle University Hospital, Rio de Janeiro, Brazil. mazzeothiago@yahoo.com.

Journal of Ophthalmic Inflammation and Infection

|December 29, 2019

Summary

Diffuse unilateral subacute neuroretinitis (DUSN) is an eye disease causing vision loss. Identifying the worm or using albendazole are key treatments, but more research is needed for optimal care.

Keywords:

Albendazole Choroiditis Eye infections Photocoagulation Retinitis Uveitis

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Area of Science:

Ophthalmology
Infectious Diseases
Parasitology

Background:

Diffuse unilateral subacute neuroretinitis (DUSN) is an infectious ocular disease causing significant vision impairment.
It typically affects young, healthy individuals and presents with characteristic retinal and optic nerve changes.
The exact cause is often attributed to parasitic worms, leading to potential autoimmune or toxic retinopathy.

Purpose of the Study:

To review the diagnosis and treatment of DUSN.
To highlight the challenges in diagnosing and treating this rare condition.
To emphasize the need for comparative studies on current treatment modalities.

Main Methods:

Review of clinical presentation, diagnostic methods (including ancillary tests like angiography and OCT), and treatment options for DUSN.
Distinction between confirmed DUSN (worm visualized) and presumed DUSN (worm not visualized).
Discussion of treatment strategies including photocoagulation, albendazole, and potential role of corticosteroids.

Main Results:

Diagnosis relies on clinical findings and, ideally, visualization of an intraocular worm.
Photocoagulation is the primary treatment for confirmed DUSN but is only feasible in 30-40% of cases.
High-dose albendazole shows promise for presumed DUSN, and corticosteroids may offer benefits.

Conclusions:

Further comparative studies are essential to determine the optimal treatment for both confirmed and presumed DUSN.
Understanding the potential autoimmune component may guide future therapeutic approaches.
Standardized treatment protocols are needed for this potentially blinding condition.