Spectral Domain Optical Coherence Tomography in Diffuse Unilateral Subacute Neuroretinitis

Abstract

Purpose. To describe the SD-OCT findings in patients with diffuse unilateral subacute neuroretinitis (DUSN) and evaluate CRT and RNFL thickness. Methods. Patients with clinical diagnosis of DUSN who were submitted to SD-OCT were included in the study. Complete ophthalmologic examination and SD-OCT were performed. Cirrus scan strategy protocols used were 200 × 200 macular cube, optic nerve head cube, and HD-5 line raster. Results. Eight patients with DUSN were included. Mean RNFL thickness was 80.25 μm and 104.75 μm for affected and normal eyes, respectively. Late stage had mean RNFL thickness of 74.83 μm compared to 96.5 μm in early stage. Mean CMT was 205.5 μm for affected eyes and 255.13 μm for normal fellow eyes. Conclusion. RNFL and CMT were thinner in DUSN eyes compared to normal eyes. Late-stage disease had more pronounced thinning compared to early-stage patients. This thinning in RNFL and CMT may reflect the low visual acuity in patients with DUSN.

Clinical experience in treatment of diffuse unilateral subretinal neuroretinitis

“…The exact pathogenesis of clinical findings seen in DUSN remain unclear, although the toxic inflammation due to larval products and immune response of host to the toxin are believed to damage the inner as well as the outer retina, hence affecting retinal nerve fiber layer (RNFL), optic nerve, and RPE, anatomically and functionally. 1 , 4 , 5 , 19 , 20…”

Diffuse Unilateral Subacute Neuroretinitis in a Healthy Korean Male: The First Case Report in Korea

“…Early diagnosis and prompt treatment with direct photocoagulation is crucial to good visual outcome in DUSN ( 10 , 11 , 12 , 18 , 19 ). Early-stage DUSN is characterized by active inflammation of the optic nerve, vitreous, outer retina, and choroid.…”

“…Early-stage DUSN is characterized by active inflammation of the optic nerve, vitreous, outer retina, and choroid. In this phase, early diagnosis and treatment can improve vision by preventing permanent damage ( 1 , 10 , 11 , 18 , 19 ). However, if DUSN is not detected or diagnosed at an early stage, permanent ocular changes, including optic atrophy, retinal arterial narrowing, and degenerative changes in the outer retina, can lead to permanent vision loss ( 1 , 11 , 12 ).…”

“…Direct-laser photocoagulation is the treatment of choice for destroying the causative worm and for preventing further damage ( 3 , 4 , 12 , 18 ). Photocoagulation does not exacerbate inflammation and results in prompt and permanent inactivation of DUSN ( 3 , 4 , 12 , 18 ). Antihelminthic treatment with albendazole is another treatment option, especially when the causative nematode has not been identified ( 3 ).…”

“…SD-OCT is a valuable diagnostic and prognostic tool during the disease course of DUSN, allowing a more precise evaluation of the retinal layers ( 18 , 19 ). In a previous case report, OCT detected fluid accumulation beneath the epiretinal membrane, identified a nematode, and showed widespread outer retinal disruption at an early stage of disease ( 19 ).…”