Intraocular cysticercosis simulating retinoblastoma in a 5-year-old child

Cysticercosis in ophthalmology

Cysticercosis is caused by Taenia solium, a cestode or tapeworm that preferentially affects the subcutaneous tissue, brain, muscle, and the eye. It is traditionally a disease of low socioeconomic regions, but large-scale population migration has made it a matter of global concern. Its ocular invasion is a potentially blinding disease. In the last two decades, there has been considerable discussion of cysticercosis; however, most comes from a limited number of case observations. Thus, to overcome this limitation, we summarize and analyse twenty years of medical literature (from 2000 to 2020) on cysticercosis in ophthalmology.

Characterization of the parasite-induced lesions in the posterior segment of the eye

Ocular lesions are frequently associated with different parasitic infections. The classes of infection include protozoa, nematodes, cestodes, and ectoparasites. Ocular parasitic infections can manifest in any part of the eye; the disease manifestations are frequently characterized as either posterior or anterior eye disease. Parasite-induced lesions may be due to damage directly caused by the parasite, indirect pathology caused by toxic products or the immune response initiated by infectious parasitism. This review characterized the parasite-induced lesions in the posterior segment of the eye. Prompt diagnosis and early treatment of these lesions can reduce ocular morbidity. The method of the literature search was conducted on PubMed, Elsevier Scopus database, and Google Scholar with no limitation on the year of publication databases. It was limited to English articles published for ocular lesions in clinical studies and was focused on parasitic infections of the eye.

Submacular Parasite Masquerading as Posterior Pole Granuloma

Parasites enter the eye through hematogenous spread. The interaction with host immune system may result in its destruction but not without collateral damage to the vital retinal structures. Currently, the accepted treatment for ocular parasitosis is surgical removal or direct laser photocoagulation. A 24-year-old Indian woman presented with abrupt painless loss of vision to 5/300. A large yellow-white lesion centered at macula was observed with associated retinal and subretinal hemorrhage and neurosensory retinal detachment. A parasite was seen protruding at the center of the lesion. Fluorescein angiography demonstrated disc leakage and vessel wall staining. Ultrasonography demonstrated a highly reflective subretinal lesion with aftershadowing. Serological test was positive for anti-cysticercus (IgM) antibody. Treatment with prednisolone and albendazole resulted in resolution of the lesion within 2 months with improvement of visual acuity to 20/400. A noncystic form of subretinal cysticercosis is likely with suggestive B-scan ultrasonography and serological investigations.

Intravitreal cysticercosis presenting as neovascular glaucoma

We report two cases of intraocular cysticercosis which showed a peculiar presentation of neovascular glaucoma which is hitherto unreported. Two young adults presented with symptoms of raised intraocular pressure due to neovascular glaucoma. On dilated fundus examination both were found to have dead intravitreal cysticercosis. The cysts were removed by a three-port vitrectomy and intracameral injection of bevacizumab was given to help in the regression of rubeosis. Trabeculectomy had to be combined in one case. The intraocular pressure returned to normal. No recurrence of rubeosis was seen even after one year.