A Rare Diagnosis With Lasting Effects

A 26-year-old man presented with decreased vision in the left eye. His medical history included panuveitis due to Toxocara retinochoroiditis 1 year prior, which was confirmed by lab testing. At that time, his left eye was successfully treated topically with 1% atropine every 12 hours and 1% prednisolone every 6 hours for 2 weeks followed by a taper. In addition, the patient was prescribed oral albendazole 400 mg twice daily and prednisone 50 mg once daily for 2 weeks followed by a taper.

At presentation to our center, the patient was 1 month post–cataract surgery in the left eye, and VA was 20/20 OD and 20/100 OS. The examination in the right eye was normal. Indirect fundoscopy in the left eye revealed a peripheral granuloma with consolidation and contraction of the lesion to the optic nerve, producing a peripheral elevated mass with retinal folds extending posteriorly. OCT of the macula showed involvement nasally with disruption of the retinal pigment epithelium layer.

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Because the patient was stable with no inflammatory signs in the anterior segment, he was prescribed artificial tears and followed closely.

DISCUSSION

Toxocara retinochoroiditis is usually diagnosed with a patient history of dog or cat exposure and clinical findings such as unilateral progressive vision loss, floaters, leukocoria, and fundoscopy findings of peripheral granuloma (20%-40%), central posterior granuloma (25%-46%), and chronic endophthalmitis (25%).¹ Diagnosis is confirmed by laboratory testing.