Retrobulbar optic nerve cysticercosis with surgical removal: a case report

Abstract

A 15-year-old boy presented with diminution of vision which rapidly progressed to no perception of light. In the ocular fundus, a neuroretinitis-like picture was seen. On CT-scan & ultrasonography, an optic nerve swelling was detected with a shadow of scolex. Medical therapy in the form of steroids along with albendazole was ineffective. Surgical removal by lateral orbitotomy was done and a complete cyst with scolex was removed, which was confirmed histopathologically as a case of retrobulbar optic nerve cysticercosis.

Optic Nerve Cysticercosis: Case Report and Review of Current Management

“…Surgical removal [7] has been carried out in one case in which medical therapy proved ineffective in restoring vision. It is not sure whether the case truly represented a failure of medical therapy as the patient presented with no perception of light, optic atrophy and macular scarring.…”

Minimally Invasive Bone-Saving Orbitotomy for Removal of Optic Nerve Cysticercosis

“…It has been described to present with a picture of neuroretinitis and has been previously managed with both conservative and surgical therapy. [1][2][3][4][5][6][7] The cases described in the literature have had isolated optic nerve involvement. The present case report describes a known case of neurocysticercosis with a secondary optic nerve involvement.…”

“…8 Surgical excision of the parasitic cyst requires careful dissection and total excision so as to prevent rupture leading to release of toxins and spread of infestation through the subarachnoid space. 7 The present case report illustrates the use of a bone-saving lateral orbital approach, through a lateral canthotomy incision leading directly to the lateral part of the optic nerve greatly facilitating dissection and removal of cyst.…”

“…[1][2][3][4][5][6][7] Although previous reports describe treatment with albendazole and steroids, 1,2 visual recovery in such cases has typically been limited. Surgical excision has been previously been described with total removal being achieved through a lateral orbitotomy.…”

“…Surgical excision has been previously been described with total removal being achieved through a lateral orbitotomy. 7 We report a case of optic nerve cysticercosis in which surgical removal was achieved after failure of medical treatment. The orbital exploration and removal was performed using a lateral canthotomy approach without bone removal, and with good recovery of vision postoperatively.…”