Treatment of Posterior Uveitis in Diffuse Unilateral Subacute Neuroretinitis (DUSN) Caused by a Subretinal Worm
Clinical scenario
Diffuse unilateral subacute neuroretinitis (DUSN) is a rare cause of posterior uveitis in which a worm present within the eye drives both direct retinal injury and significant intraocular inflammation. DUSN is typically unilateral, and the presence of an identifiable subretinal worm is the defining feature that shapes the treatment decision.
Key consideration
Whether or not a live worm is visualised on examination is the central fork in management. The worm and its by-products can cause severe inflammation affecting the optic nerve head and the retina, making timely intervention important.
Treatment approach (partial)
When a live worm is detected, the primary intervention is aimed directly at the worm itself, combined with systemic treatment to control the associated inflammation. When a worm cannot be identified, an antiparasitic agent is used.
Full regimen details — dosing, sequencing, and monitoring — are available in the structured protocol below.
References
- DUSN, a rare entity caused by a worm in the eye, is usually unilateral.
- Live worm, if detected, can be destroyed by direct laser application.
- Worm and its by-products can cause severe inflammation affecting the optic nerve head and retina and needs to be treated with high-dose systemic steroids.
- Treatment with albendazole is beneficial.
DOI: 10.4103/0301-4738.58470