Enface vitreous OCT ‘worm holes’: A novel finding in a patient with diffuse unilateral subacute neuroretinitis (DUSN)

Abstract

Purpose To describe a case of diffuse unilateral subacute neuroretinitis (DUSN), a rare condition that causes progressive vision loss following infection by a nematode using enface vitreous imaging. Observations We present the clinical findings of a 37-year-old female, clinically diagnosed with DUSN after a non-invasive multimodal imaging approach that included MultiColor scanning laser imaging and enface vitreous OCT, which revealed the nematode body and lacunae created by worm migration, respectively. Conclusion and importance To our knowledge, this is the first reported case of lacunae visualized using enface vitreous optical coherence tomography (OCT), potentially marking the migration path of the nematode.

Diffuse Unilateral Subacute Neuroretinitis: Challenges in Diagnosis and Management

“…The presence of a subretinal track is suggestive of the movement of the nematode with local inflammation. In the later stages, severe visual loss, optic atrophy, narrowing of retinal vessels, and degeneration of retinal pigment epithelium are noted [8][9][10][11][12][13].…”

“…The exact subtype of the nematode was not known. The nematodes in DUSN can either be smaller (400-1,000 µm) or larger (1,500-2,000 µm) [4,13,14].…”