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December 1996

Subretinal Migration of a Nematode in a Patient With Diffuse Unilateral Subacute Neuroretinitis

Author Affiliations

Nashville, Tenn

Arch Ophthalmol. 1996;114(12):1526-1527. doi:10.1001/archopht.1996.01100140724018

This otherwise healthy 20-year-old man experienced blurred vision in the right eye. His visual acuities were 20/40 OD and 20/20 OS. In the right macula, vitreous cells (+1) and multiple yellow-white lesions at the level of the outer sensory retina and pigment epithelium were present (Figure, A). The left eye was normal. Angiographically, the yellowwhite lesions in the right eye were hypofluorescent early and stained late; the slightly swollen optic disc stained late (Figure, B and C). These changes were initially diagnosed as unilateral acute posterior multifocal placoid pigment epitheliopathy. Four days later, the lesions in the macula had faded, and new lesions appeared inferior to the macula (Figure, D); diffuse unilateral subacute neuroretinitis was suspected. During the next week, the patient returned every other day for contact lens examination of the fundus and fundus photographs. The subretinal nematode that was clearly visible in the photographs (Figure A through F)

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