Título / Title

DIFFUSE UNILATERAL SUBACUTE NEURORETINITIS (DUSN): FINDINGS ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AND FLUORESCEIN ANGIOGRAPHY

Introdução / Purpose

To report the case of a patient with Diffuse Unilateral Subacute Neuroretinitis (DUSN).

Material e Método / Methods

Case report.

Resultados / Results

A 25-years-old white woman complaining of vision loss in the left eye (OS) for 4 years. Medical, ophthalmological and family history were unremarkable. Eye examination showed nystagmus, best corrected visual acuity (BCVA) was 20/20 on right eye (OD) and hand movements on OS. Biomicroscopy of the anterior segment showed discrete posterior subcapsular cataract on OS, quiet anterior chamber (AC) and intraocular pressure was 18 and 12 mmHg in OD and OS, respectively. During the fundus examination the OD was unremarkable and the OS had a pale optic nerve disc, attenuation of the retinal vasculature and diffuse mottling of the RPE (figure 1, 2). The FFA showed absence of retinal blood flow and the OCT revealed diffuse retinal atrophy (figure 3, 4, 5). Diagnosis was Diffuse Unilateral Subacute Neuroretinitis (DUSN).

Discussão e Conclusões / Conclusion

DUSN is a syndrome caused by a nematoid which reaches and moves through the subretinal space and the vitreous cavity. Its size varies between 200 and 400µ. The probable agents are Ancylostoma canium and Bayliscaris procyonis which may cause as initial presentation papillitis, vasculitis and light to moderate vitreitis. In the chronic stage optic nerve atrophy and vascular attenuation are more commonly observed, as in this case report. The treatment is based on photocoagulation of the nematoid when it is visible and systemic use of Albendazol in the active stage.

Palavras Chave

Uveitis; Eye Infections, Parasitic; Tomography, Optical Coherence.