Ocular angiostrongyliasis in Thailand: a retrospective analysis over two decades

Figures & data

Table 1 Patient demographic data, ocular findings, management, and visual outcome

Sex	Age (y)	Meningitis	Duration (weeks)	Ocular exam (initial)					Investigation		Treatment				Final VA
				Eye	Location	VA	RAPD	Ocular findings	Eosino-philia	Stool exam (eggs)	Laser	Antihelminthic	Steroid	PR
M	27	Preceded	3	Left	Intravitreal	1/60	+	Chorioretinitis, subretinal track	–	NA	+	Albendazole ×7	Topical prednisolone	+	1/60
M	21	Coexisting	1	Left	Intravitreal	2/60	+	RPE alteration	+	NA	+	—	Oral prednisolone	–	2/60
M	47	—	3	Left	Intracameral	CF	+	RPE alteration, disk swelling, intraretinal hge	NA	Sarcocystis Opisthorchis	+	Albendazole ×14	IV, oral, topical prednisolone	+	1/60
F	44	—	0.5	Right	Subretinal	LP	+	Subconjunctival hge subretinal track, serous RD, macular opacification, peripapillary hge, vitreous hge	NA	Not found	+	Albendazole ×14, ivermectin once	Oral, topical prednisolone	–	no LP
F	36	Preceded	1	Left	Intravitreal	CF	+	RPE alteration, disk swelling	+	NA	+	—	Oral prednisolone	+	CF
F	41	—	4	Left	Subtenon	6/6	–	Conjunctival injection	NA	Enterobius, hookworm	–	Albendazole ×7	Topical prednisolone, subconjunctival dexa	+	6/6
M	50	—	2	Left	Subretinal	CF	+	RPE alteration, subretinal track	+	Not found	+	Albendazole ×7	Topical prednisolone	+	CF
M	76	—	2	Right	Intracameral	6/60	–	Corneal scar, fibrin in anterior chamber	NA	Opisthorchis	–	Praziquantel ×7	Topical prednisolone	+	6/36
F	63	—	8	Left	Intracameral	LP	–	Corneal scar, hyphema, vitreous hge, preretinal hge	–	Not found	–	Albendazole ×7	Topical prednisolone, Subconjunctival dexa	+	HM
F	51	—	2	Left	Intravitreal*	HM	–	Focal iris atrophy, choroiditis	+	Strongyloides larva	+	Albendazole ×7	Topical prednisolone	–	HM
F	22	—	8	Right	Intravitreal	1/60	+	RPE alteration, disk swelling	–	NA	–	—	Oral prednisolone	+	1/60
F	28	—	0.5	Right	Subretinal	6/24	–	Subretinal track	–	NA	+	—	Oral prednisolone	–	6/24
M	36	—	1	Right	Subretinal	CF	+	Macular edema	NA	Echinostoma	+	Albendazole ×7	Topical prednisolone	+	2/60
M	39	—	1.5	Right	Intravitreal	6/6	–	—	NA	NA	+	—	—	–	6/6
F	33	—	1	Left	Subretinal	1/60	+	RPE alteration	–	NA	+	—	Oral prednisolone	–	5/60
M	27	—	4	Right	Subretinal	CF	+	Subretinal track	NA	NA	+	Albendazole ×7	-	–	CF
M	46	—	3	Right	Intracameral	CF	+	RPE alteration, vitritis	–	NA	+	—	Oral, topical prednisolone	+	CF
M	46	—	1	Right	Intravitreal	CF	+	RPE alteration, vitritis	–	Not found	+	Albendazole ×7	Topical prednisolone	+	6/60

Note: *The parasite migrated from anterior chamber to vitreous cavity.

Abbreviations: VA, visual acuity; CF, counting finger; hge, hemorrhage; HM, hand motion; LP, light perception; PR, parasitic removal; RPE, retinal pigment epithelium; dexa, dexamethasone; RAPD, relative afferent pupillary defect; NA, not available.

Figure 1 Angiostrongylus cantonensis larvae in subtenon space (A), aqeous humour (B), vitreous cavity (C), and subretinal space (D).

Figure 2 Large subretinal angiostrongyliasis with severe disk hemorrhage and extensive retinal whitening.