Purchase this article with an account.
B. Lumbroso, S. Abbruzzese, G. M. Pedone, M. Rispoli, S. Catalano; Importance of Optical Coherence Tomography Spectral Analysis in Sub-retinal Cysticercosis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3264.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe a rare case of possible ocular cysticercosis and demonstrate the importance of OCT spectral analysis in cases of negative serologic tests.
A 76-year-old butcher man noted a progressive lowering of visual acuity in his right eye. He underwent complete sierologic, radiologic (NMR, CT) and ophthalmological exams, including ultrasonography, retinography, fluoangiography, indocyanine green and OCT (OCT/SLO OTI-OPKO and Zeiss Cirrus).
The patient had a persistent mild hypereosinophilia, combined with high hemosedimentation rate (74 mmh) and polymerase chain reaction. Mantoux tuberculin skin test, Interferon-Gamma Release Assay for the diagnosis of latent tuberculosis infection and sierological tests were all negative. Orbital CT scan was normal. Brain ad orbital RMN with gadolinium disclosed an oval lesion in the inner retinal layer (3.0 x 1.5 mm), peripherally to the optical nerve. A low signal T2 sequence characterized the lesion. Biomicroscopy and tonometry were normal. Visual acuity was 20/30 in right eye and 20/20 in left eye. The biomicroscopy of left eye was normal. On right eye was detected a juxtafoveal cystic lesion. The retinography and the FAG confirmed the lesion. Ultrasonography showed an intra-retinal solid lesion. The OCT disclosed an elevation of the RPE with cystoid oedema of the inner nuclear layer. A nodular, delimited and more reflective lesion was clearly visible below the elevation. The shadow created by the high density of the inner wall of the lesion, masks all lesion contents beneath it and probably unharmed RPE-choriocapillaris layer complex. Frontal en face C-scans evidentiate the lesion structure. High resolution scans of the retina with three-dimensional images demonstrate the cystic lesion. The lesion causes swelling and separation of the retina layers.
Although only the histopathological study can confirm the clinical suspicion of cysticercosis, the OCT may be an important screening and follow-up management to investigate patients with cysticercosis, mainly in cases of negative sierologic tests.
This PDF is available to Subscribers Only