Diffuse Unilateral Subacute Neuroretinitis Treatment & Management

Updated: Dec 14, 2015
  • Author: Lakshmana M Kooragayala, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Treatment

Medical Care

Laser photocoagulation of the nematode is the treatment of choice. [19, 20] Direct laser photocoagulation has been effective in destroying the worm. In early stages of DUSN, prompt localization and destruction of the worm by photocoagulation may improve the vision of patients, and, in other situations, the progression of the disease is halted. No significant intraocular inflammation has been associated with this treatment. If worms cannot be localized, application of laser along the edges of active lesions may decrease the morbidity and improve vision. [21]

Antihelminthic treatment is being used more frequently. It may be considered when the organism cannot be found.

Combination therapy (eg, laser treatment, systemic steroids, anthelminthics) is also used. [22]

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Surgical Care

Although direct laser photocoagulation of the nematode is the treatment of choice for DUSN, surgical transvitreal removal of the nematode may be indicated in selected cases. [23]

Pars plana vitrectomy and removal of an intact parasite by various vitrectomy instrumentation allow removal of the nematode for parasitologic identification. [24]

In addition, the inflammation may completely subside with recovery of function.

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Consultations

Consultation with a uveitis or retinal specialist is often useful for patients with suspected DUSN.

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