Diffuse bilateral subacute neuroretinitis: first patient with documented nematodes in both eyes.

OBJECTIVE: To describe the first patient with documented evidence of diffuse unilateral subacute neuroretinitis (DUSN) in both eyes. METHODS: A 10-year-old healthy Brazilian girl was first seen with signs of late-stage DUSN in both eyes. A careful search for a nematode was performed in each eye. RESULTS: A motile 550- to 660-microm nematode was found in the inferotemporal retina of the left eye. A similar-sized motile nematode was found in the superotemporal retina of the right eye. Both nematodes were treated with argon green laser applications with bilateral improvement of visual function. CONCLUSION: Although most patients with DUSN do not develop the disease in the fellow eye, this case demonstrates that DUSN can occasionally affect both eyes.

Diffuse unilateral subacute neuroretinitis. Report of transvitreal surgical removal of a subretinal nematode.

BACKGROUND: The precise identification of nematodes which cause diffuse unilateral subacute neuroretinitis (DUSN) has been unsuccessful. Shape and size are useful in the initial stages of identification, but histopathologic examination usually is necessary for accurate classification. Intact nematodes recovered from patients with DUSN have been mentioned scarcely in the literature. The authors report the first case of DUSN in which a viable nematode was removed successfully via a transvitreal surgical approach and recovered for parasitologic study. METHODS: Bimanual pars plana vitrectomy was performed in a 9-year-old Brazilian boy with typical DUSN in its late stage. During surgery, a motile subretinal nematode was confirmed temporal to the macular area. A retinotomy was created adjacent to the nematode. The subretinal material then was aspirated with a 20-gauge soft-tip needle, and parasitologic examination was performed. RESULTS: Based on length (630 m x 10(-6)) and width (30 m x 10(-6)) of the nematode and other features such as a small buccal capsule, an esophagus one third of body length, and tapered tail, a morphologic identification of the nematode was made as a third-stage Toxocara larva. Histopathologic examination could not be performed for confirmation because of subsequent deterioration of the specimen. CONCLUSIONS: 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. This method for treatment allows removal of the nematode for parasitologic identification.

Ferimentos perfurantes oculares com lesao cristaliniana: consideracoes sobre a conduta cirurgica inicial. / Perforating ocular injuries with crystallins injuries: considerations on the initial surgical procedure

Os autores realizaram um estudo retrospectivo envolvendo 52 pacientes com lesao cristalina entre 411 pacientes com FPO nos quais no ato cirurgico inicial nao se realizou remocao completa das massas. Destacam que apenas 3 deles (5,8%) apresentaram reabsorcao expontanea com acuidade visual final de 20/60 e 20/25. Concluem pela necessidade de remocao das massas quando houver seguranca no diagnostico de presenca delas em camara anterior bem como de vitrectomia anterior quando do envolvimento do segmento posterior

Vitrectomia via pars plana. (Sistema automatizado de aspiracao e focalizacao). / Pars plana vitrectomy (automated system of aspiration and focalization

Os autores descrevem a construcao de um sistema de aspiracao e focalizacao automatizado usado em vitrectomia via pars plana

Vitrectomia via pars plana no tratamento cirurgico do descolamento da retina. / Pars plana vitrectomy in the surgical treatment of retinal detachment

Dez pacientes portadores de descolamento regmatogenico da retina, associado a diversas de opacidade dos meios transparentes oculares foram submetidos a vitrectomia via pars plana concomitante a cirurgia de introflexao escleral. Obteve-se sucesso em 30% dos casos