A 23-year-old man presented for follow-up of ocular toxocariasis (OT), diagnosed 5 years prior during an evaluation for vitritis and chorioretinal granuloma. Diagnosis was confirmed through serum and aqueous humor Toxocara canis antibodies, and treatment with albendazole and oral steroids was instituted. Treatment resulted in inflammation improvement; however, macular scarring led to permanent vision loss. Ultra-widefield color fundus photographs taken at consecutive 4-month intervals revealed a linear image (Figure, A) compatible with a live larva. This was corroborated by optical coherence tomography as a hyperreflective element in the subretinal space of the detached retina (Figure, B). Diagnosis of OT is generally presumptive, with larva demonstration occurring only in rare cases.1,2 Treatment remains controversial; options include albendazole with adjunctive photocoagulation (impossible in this case due to detached retina) or vitrectomy.3,4 Considering the stable cicatricial findings and the poor visual prognosis, it was decided to withhold any course of treatment and closely monitor the patient for recurrence.
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Corresponding Author: Sara Geada, MD, Department of Ophthalmology, Centro Hospitalar e Universitario de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal (email@example.com).
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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