Ng, Guan Fook and Abd Aziz, Hayati and Raja Azmi, Mohd Noor and Ahmad Tajudin, Liza Sharmini and Wan Hitam, Wan Hazabbah and Embong, Zunaina
(2012)
Diffuse unilateral subacute neuroretinitis in a young boy: a case report.
Clinical Ophthalmology, 2012 (6).
pp. 487-490.
ISSN 1177-5467
Abstract
We report a case of diffuse unilateral subacute neuroretinitis in a young boy with
no clinical visualization of nematode. The diagnosis was made based on clinical findings and
detection of Toxocara immunoglobulin G by Western blot test. An 11-year-old Malay boy
presented with progressive blurring of vision in the left eye for a duration of 1 year. It was
associated with intermittent floaters. Visual acuity in the left eye was 6/45 and improved to 6/24
with pinhole. There was positive relative afferent pupillary defect, impaired color vision, and
presence of red desaturation in the left eye. There were occasional cells in the anterior chamber
with no conjunctiva injection. Posterior segment examination revealed mild-to-moderate
vitritis and generalized pigmentary changes of the retina with attenuated vessels. The optic
disk was slightly hyperemic with mild edema. There was presence of multiple, focal, graywhite
subretinal lesions at the inferior part of the retina. Full blood picture results showed
eosinophilia with detection of Toxocara immunoglobulin G by Western blot test. Investigations
for other infective causes and connective tissue diseases were negative. The diagnosis of diffuse
unilateral subacute neuroretinitis secondary to Toxocara was made based on clinical findings
and laboratory results. He was treated with oral albendazole 400 mg daily for 5 days and oral
prednisolone 1 mg/kg with tapering doses over 6 weeks. At 1 month follow-up, the inflammation
had reduced, and multiple, focal, gray-white subretinal lesions were resolved; however there
was no improvement of vision.
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