Multifocal Chorioretinitis with Serous Macular Detachment in Diffuse Unilateral Subacute Neuroretinitis (DUSN): Unique Presentation and a Diagnostic Dilemma

ABSTRACT

Purpose

To report a case of multifocal chorioretinitis with serous macular detachment in diffuse unilateral subacute neuroretinitis (DUSN) and its diagnostic dilemma.

Design

Case report

Method

A 43-year-old woman presented with painless diminution of vision of right eye for 1 week. Dilated fundoscopy showed mild disc edema, multiple deep grey-white retinitis lesions in posterior pole with mild vitritis. Optical coherence tomography revealed serous macular detachment. Fundus fluorescein angiography was suggestive of active retinitis. Comprehensive workup was unremarkable. Six days later, a live subretinal worm was noticed in inferotemporal retina. A diagnosis of DUSN was made and treated with laser photocoagulation followed by antihelminthic therapy. One month later, patients vision improved and chorioretinal lesions also healed.

Conclusion

This report presents a unique scenario of serous macular detachment in DUSN in addition to commonly seen multifocal deep retinitis lesions. Prompt treatment with laser, antihelminthic agent can prevent irreversible vision loss.

KEYWORDS:

• Diffuse unilateral subacute neuroretinitis
• multifocal choroiditis
• serous macular detachment

Consent

Consent for publication of data and images have been obtained from the patient.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.