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Q Nguyen, DV Do, E Letko, T Hirose, CS Foster; Unilateral Chorioretinitis and Subretinal Neovascularization Associated with Eosinophilic Enteritis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4289.
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Purpose: Eosinophilic enteritis (EE) is defined by the presence of intestinal symptoms and eosinophilic infiltration, traditionally in the absence of extra-intestinal organ involvement. Peripheral blood eosinophilia is found in the majority of patients. EE is common in Australia and is often associated with infection by the common dog hookworm Ancylostoma caninum, although other worms have been identified. We hereby describe a case of unusual unilateral chorioretinitis and subretinal neovascularization in a young boy with eosinophilic enteritis. Methods: Report of a single, observational case. Results: A 10-year-old Caucasian boy (dog-owner) presented with unilateral, painless, subacute loss of vision. Two months previously, visual acuity (VA) in the left eye was correctable to 20/30. On presentation, VA was 20/20 OD and counting finger (CF) OS. Anterior segments were normal. The right fundus was unremarkable. The left fundus had an extensive, creamy, central chorioretinal lesion that extended from the nasal area of the optic nerve to the temporal region of the macula. Fluorescein angiography revealed massive subretinal neovascularization within the lesion. Extensive uveitic, neurologic, oncologic, and infectious evaluations were performed and did not disclose any etiology. The only associated factor was a history of eosinophilic enteritis diagnosed by colonic biopsy at age 3. The patient had peripheral blood eosinophilia at the time of ocular disease. There was no available serologic testing in America for A. caninum. Retinal biopsy was declined. The patient and family chose to be monitored without interventions. One year later, the subretinal neovascularization became fibrotic. VA remained at 20/20 OD and CF OS with functional peripheral vision; the right eye remained uninvolved. Conclusion: Eosinophilic enteritis may be associated with ocular disease. The index case may be the first one reported. Ophthalmic manifestation may present years after initial presentation of EE. Peripheral blood eosinophilia may be helpful in supporting the diagnosis. Ocular disease may remain self-limited.
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