DIFUSE UNILATERAL SUBACUTE NEURORRETINITIS (DUSN): CASE REPORT
To report a case and discuss the topic.
A single case report and literature review. A female patient, BFM, 20 years, comes to our service presenting visual acuity of anteface finger count and 1.0 without correction in right and left eye respectively. The anterior biomicroscopy did not present alterations. Fundoscopy showed optic disc palisades, vascular narrowing, retinal pigment epithelial atrophy, and white-gray lesions throughout the peripheral region. Fluorescein angiography revealed optic disk pallor, increased brightness of the retinal internal limiting membrane, changes in RPE, and arteriolar narrowing. ERG showed a selective reduction in B wave. Serology was used for Toxocaracanis that showed positive IgG. Thus the diagnosis of DUSN was confirmed.
Patient is being followed up at our service.
DUSN is an infectious disease primarily described in 1978 by Gass and Scelfo. It is a larvae whose etiology was not well established, responsible for promoting an inflammatory and degenerative process in the posterior retina. In some cases it is possible to visualize the larvae atfundoscopy. The main agents are Ancylostomacaninum and Baylisascarisprocyonis. The clinical picture is abnormalities of visual acuity that usually happen with irreversible optical atrophy. Other symptoms such as the presence of scotomas are described. The diagnosis is made through a serological test. Other exams such as OCT, AGF, and electroretinogram may be useful for diagnosis. The only recommended treatment is laser photocoagulation for larval destruction, but there is no improvement in visual prognosis.
DUSN; Toxocara; Neurorretinitis
CLINICAL RETINA
Dr João Penido Burnier - São Paulo - Brasil
Guilherme Ferreira Bandeira Coelho Dias, Mariana Botelho Dias Souza, Vinicius Clementino Falcão, Tiago Almeida Carvalho, Milena Cristina Silva Almeida, Rafael Nojiri Moreira, Felipe Peterman Bugalho, Marcio Augusto Nogueira Costa