Diffuse unilateral subacute neuroretinitis.
BACKGROUND
Diffuse unilateral subacute neuroretinitis (DUSN) is an inflammatory disorder of the retina thought to be caused by a motile worm. It initially presents with unilateral recurring crops of gray-white retinal lesions and mild to severe inflammation. Over a period of months, diffuse retinal pigment epithelium (RPE) changes, arteriolar attenuation, and optic atrophy will develop. In approximately 25% of cases, a worm is visualized during the eye examination. Laser treatment to kill the worm is the only reliable way to halt progression of this disease.


METHODS
The following case report presents a 9-year-old girl with unilateral vision loss.


RESULTS
Clinical observation and several blood tests to rule out systemic diseases resulted in a diagnosis of DUSN. Although a worm was not visualized, laser treatment of its suspected location resulted in recovery of some vision.


CONCLUSIONS
DUSN is often diagnosed by clinical presentation alone, because a worm may not be visualized. An appropriate initial work-up and timely initiation of laser treatment are essential to preservation of vision.
Stokkermans
T J
TJ
Bascom Palmer Eye Institute, Miami, Florida, USA. stokkerman@aol.com
D000208:Acute Disease; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D053685:Laser Therapy; D009349:Nematode Infections / Q000150:complications; D012173:Retinitis / Q000175:diagnosis* / Q000469:parasitology / Q000503:physiopathology / Q000628:therapy*; D014785:Vision, Ocular / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology