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CASE REPORT
Year : 2016  |  Volume : 11  |  Issue : 1  |  Page : 116-119

Successful management of diffuse unilateral subacute neuroretinitis with anthelmintics, and intravitreal triamcinolone followed by laser photocoagulation


1 Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences; Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Surgery, Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Durham, NC, USA

Correspondence Address:
Alireza Ramezani
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave., Tehran 16666
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2008-322X.180704

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Purpose: Diffuse unilateral subacute neuroretinitis (DUSN), a form of posterior uveitis, is secondary to the presence of a highly motile nematode in the intraretinal or subretinal space. Herein, we report a case of DUSN that was successfully managed by an intravitreal injection of triamcinolone and laser therapy. Case Report: A middle-aged man with complaint of decreased vision and marked unilateral vitritis and neuroretinitis. Fluorescein angiography revealed disc leakage, vessel wall staining, and diffuse track-like transmission defects of the RPE. Optical coherence tomography confirmed the subretinal location of the worm. The patient received oral thiabendazole and an intravitreal injection of triamcinolone acetonide. After 10 days, media haziness decreased, and a live motile subretinal worm was identified. Direct laser photocoagulation was performed to destroy the worm. After two months, a localized chorioretinal scar developed and no further active inflammation and subretinal worms were detected. Conclusion: Intravitreal steroids can be used safely in cases with DUSN and may help detect the causative worm for applying laser photocoagulation.


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