Patient Presentation: A 9-year-old previously healthy girl presented with progressive, painless vision loss in her left eye over 2 weeks. Her past ocular history was unremarkable. A complete physical examination including a neurological assessment was within normal limits. Her BCVA was 20/20 OD and HM OS, and anterior segment examination was unremarkable. A dilated fundus exam was performed and the fundus image for the left eye is shown below:
Question: Describe the main findings.
On further questioning, her parents reported a large raccoon population in their neighborhood and the presence of raccoon stool on their porch.
Question: What condition are these findings consistent with?
OCT HD5 Line Raster was performed overlying the worm.
Question: What layer of the retina is the worm located?
OCT macula was performed in the left eye over the fovea and shown below:
Question: What is the main abnormality on this OCT?
Question: Which of the following is an appropriate treatment option for this patient?
With photocoagulation, the worm was found to be immobilized on fundus examination.
For more information, see case report: https://pubmed.ncbi.nlm.nih.gov/27434904/
Recognize features of DUSN that help distinguish it from other conditions causing unilateral vision loss.
Recognize key features of early and late stage DUSN.
Recognize the treatment options for DUSN.