Diffuse Unilateral Subacute Neuroretinitis in Young Adolescents: A Case Series

We demonstrated four patients with diffuse unilateral subacute neuroretinitis in young adolescents with good visual outcome which diagnosed from May 2020 until April 2021. All patients presented at early stage of the disease and the main complaint was reduced unilateral vision within 2 weeks duration. Systemic examinations and investigations were unremarkable except eosinophilia in case 1. Visual acuities during presentation ranged from 6/6 to 2/60. Anterior chamber inflammation noted in case 1 and 2. Fundus examinations in all patients revealed swollen optic disc, dilated and tortuous vessels, vasculitis, macular edema, presence of cluster deep yellow-white retinal lesions and varying degrees of vitritis except in case 4 , absence of macular edema. The worms were identified 2 weeks later in case 1 and one month later in case 4. A combination of oral albendazole 400 mg once daily and oral prednisolone (0.5 mg/kg daily with a weekly taper) were prescribed to all patients for 4-6 weeks except in case 4 was not prescribed with oral prednisolone. All patients responded well to oral medications. Both case 1 and 4 with visible motile worm treated with laser photocoagulation. Following treatments, no new retinal lesion seen and all patients achieved best corrected final best corrected visual acuity of 6/9 or better.