Short-term oral albendazole therapy for diffuse unilateral subacute neuroretinitis: A case report

Abstract

Purpose To report on a case of diffuse unilateral subacute neuroretinitis (DUSN) that was successfully treated with a short course of oral albendazole. Observations A 51-year-old male presented with severe visual loss secondary to DUSN associated with a positive Toxocara serology. Because the parasite could not be detected on fundoscopy, first-line treatment with photocoagulation could not be administered. Treatment with a 6-day course of oral albendazole resulted in the resolution of DUSN as well as the restoration of visual acuity. Conclusion and importance Although DUSN is characterized by the presence of a parasitic organism in the retina, there are cases in which the parasite is not visible. Albendazole has been used to treat such cases, but a standard treatment regimen has not been determined yet. Our case suggests that the resolution of DUSN can be achieved with short-term albendazole therapy.

Diffuse Unilateral Subacute Neuroretinitis: Challenges in Diagnosis and Management

“…Oral anti-helminthic agents are the mainstay of treatment in cases of presumed DUSN. Most reported cases used oral albendazole 400 mg daily for 30 days, and one study by Amaral et al used only six days of oral albendazole 400 mg daily [16]. All cases showed good visual outcomes with no side effects.…”

“…DUSN is also described as unilateral wipe-out syndrome as the disease eventually results in optic atrophy, narrowing of major vessels, and retinal pigment epithelial cell degeneration, leading to poor visual outcomes [16]. The degree of inflammation in DUSN depends on the immune response of the patient [18].…”