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CA A. Garcia Filho, A H Gomes, P de S Segundo, A C M. Soares, C A A. Garcia; Clinical Features Of 171 Patients With DUSN. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2735.
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Diffuse unilateral subacute neuroretinitis is an ocular infectious disease caused by a motile nematode leading to vision loss as a result of inflammation and degeneration of the retina. The clinical findings in patients with DUSN can be divided into an early stage and a late stage. The objective of the study is to evaluate the determinant clinical signs to diagnose DUSN and it’s treatment results.
This is a retrospective study in which the clinical charts of a series of patients diagnosed with DUSN at the Federal University of Rio Grande do Norte (Brazil) were reviewed. Patients included in the study had clinical diagnosis of DUSN based on the criteria described by Gass and Scelfo. Patients in early or late stages of the disease were included in the study. All patients underwent complete ophthalmologic examination. The patients included in the study had a minimum of six months follow-up. Statistical analysis was performed using Paired Student’s t-test, Pearson’s x2 and Fisher’s exact test. A significance level of 5% was set.
A total of 171 patients were evaluated. There were no difference in the gender commitment. Most of the patients were younger than 20 years old (69.6%). 12 patients presented in the early stage of the disease (7%) and 159 (93%) in the late stage. The subretinal worm was identified in 87 patients (50.8%). The most common location of the nematode was the posterior pole (21.6%). It was observed that the younger the age the higher the indices of larvae finding (p=0.022). The frequency of DUSN clinical signs is shown in figure 1. White yellowish spots and vitreitis were statistically correlated with the identification of the worm (p=0.001). Mean logMAR BCVA before laser treatment was 1.446 and post-laser treatment was 1.281 (p<0.05).
The identification of the clinical signs and the diagnosis of DUSN in its early stage followed by prompt location and destruction of the worm by photocoagulation may improve vision of affected patients.
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