Diffuse unilateral subacute neuroretinitis.
BACKGROUND
In patients with diffuse unilateral subacute neuroretinitis (DUSN), the presence and, therefore, clinical visualization of subretinal nematode makes the diagnosis obvious. However when located under the retinal pigment epithelium (RPE), diagnosis is presumptive and challenging. We report a case of presumed DUSN to illustrate this diagnostic dilemma and to highlight the clinical signs which suggest the diagnosis.


METHODS
Case report of a patient with DUSN.


RESULTS
In our patient the nematode was not located subretinally and this made the diagnosis difficult. However, the appearance of sub-RPE serpiginous tract in the infero-temporal retina, peripheral RPE hypopigmentation and good clinical response to anti-helminthics supported the diagnosis.


CONCLUSIONS
It is important to have a high index of suspicion when patients present with a combination of above findings. This will help in early control of ocular inflammation and salvaging vision.
Anshu
Arundhati
A
Singapore National Eye Centre, 11, Third Hospital Avenue, Singapore 168751, Singapore. trians@singnet.com.sg
Chee
Soon Phaik
SP
D002648:Child; D015822:Eye Infections, Parasitic / Q000175:diagnosis* / Q000469:parasitology; D005260:Female; D006801:Humans; D009349:Nematode Infections / Q000175:diagnosis* / Q000469:parasitology; D010857:Pigment Epithelium of Eye / Q000469:parasitology; D012173:Retinitis / Q000175:diagnosis* / Q000469:parasitology