Título / Title

NEURORETINITIS AND MACULAR EDEMA FOR TOXOCARIASIS WITH EXCELLENT RESPONSE TO SPECIFIC TREATMENT

Introdução / Purpose

To describe the clinical characteristics of a patient with neuroretinitis associated with macular edema, initially treated as Toxoplasmosis, but then the diagnosis changed to Toxocariasis with excellent response to the specific treatment.

Material e Método / Methods

Case report: A 22-year-old female patient. Refer sudden low visual acuity in the left eye (LE) 3 days ago and ocular pain, which worsens to eye movement. No fever or other symptoms.
March / 2017: Visual acuity with correction RE: 20/20 LE: MH 1m
Eye reflexes: RE: unremarkable LE: RAPDs (+++)
Biomicroscopy RE: unremarkable. LE: Traces of cells in anterior chamber ++ and anterior vitreous ++
Fundoscopy: RE: unremarkable. LE: swelling optic discs, hyperpigmented lesion superior to macula in the upper temporal arcade with active lesion of retinochoroiditis at the border, associated with macular edema.
Results of serologist: CMV, Herpes virus, Toxoplasmosis were IgG Reagents, Bartonela IgG Non-reagent

Resultados / Results

For the initial lesion in LE (apparent lesion of Toxoplasmosis) the initial treatment with Sulfadiazine / Pyrimethamine + folinic acid and eye drops Dexamethasone + tropicamide were started in LE. The patient didn't tolerate the medication (vomiting), used only for 2 days, with worsening of the ocular condition.
On the 7-day return, optical coherence tomography showed a choroidal granuloma
The research for Toxocariasis was expanded and the result of serologist for Toxocara IgG Reagent (1/ 205)
CONDUCT: Albendazol 800mg daily for 30 days and eye drops Dexamethasone tid + Tropicamide bid with improvement of macular edema. After a year of follow-up with no recurrence of the condition.

Discussão e Conclusões / Conclusion

Toxocara neuroretinitis is an uncommon presentation, in this patient after improvement of the edema, a granulomatous lesion was detected that simulated chorioretinitie by Toxoplasmosis. being extended the research for Toxocariasis with compatible serology, having excellent response to treatment with Albendazole.

Palavras Chave

Neuroretinitis, toxocariasis, macular edema