Journal List > J Korean Ophthalmol Soc > v.54(10) > 1009517

J Korean Ophthalmol Soc. 2013 Oct;54(10):1610-1613. Korean.
Published online October 16, 2013.  https://doi.org/10.3341/jkos.2013.54.10.1610
Copyright © 2013 The Korean Ophthalmological Society
A Case of Intravitreal Cysticercosis with Neovascular Glaucoma
Jae Sang Ko, MD,1 Gyu Ah Kim, MD,1,2 Joo Youn Shin, MD,1 and Suk Ho Byeon, MD, PhD1
1Department of Ophthalmology, EYE and ENT Hospital, Severance Hospital, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
2Siloam Eye Hospital, Seoul, Korea.

Address reprint requests to Suk Ho Byeon, MD, PhD. Department of Ophthalmology, Severance Hospital, #50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-3570, Fax: 82-2-312-0541, Email: shbyeon@yuhs.ac
Received April 26, 2013; Revised June 17, 2013; Accepted August 24, 2013.

Abstract

Purpose

To introduce a case of intravitreal cysticercosis presenting as neovascular glaucoma.

Case summary

A 42-year-old female who lives in the Philippines visited our clinic complaining of reduced visual acuity and decreased visual field in her right eye. She was treated at another clinic for neovascular glaucoma and posterior uveitis. Initial best-corrected visual acuity was 0.7 and intraocular pressure was 13 mm Hg with Goldmann applanation tonometry. Slit lamp examination showed inflammatory cells in the anterior chamber and vitreous with florid new vessel on iris. On fundus examination, a cystic lesion without movement was observed in the superonasal vitreous as well as tractional band. As other retinal vascular diseases were not observed on fluorescein angiography, the patient was diagnosed with secondary neovascular glaucoma due to cysticercosis. After a single course of intravitreal bevacizumab injection and cyst removal with pars plana vitrectomy, the best-corrected visual acuity was 0.5 and intraocular pressure was 14 mm Hg without recurrence of iris neovascularization during the 3 months of follow-up.

Keywords: Intravitreal cysticercosis; Neovascular glaucoma

Figures


Figure 1
Intravitreal cystic lesion is noted at the superonasal periphery. (A) Tractional band is present from the cystic lesion to the optic nerve. There is no sign of scolex in the cysts. (B) Note the retinal break behind the retinal cystic lesion, which is regarded as the parasite entry site.
Click for larger image


Figure 2
Unltasound B-scan shows curvilinear high echo corresponding to the cyst wall of intravitreal cysicercosis. Note the high amplitude of the anterior and posterior cyst wall and lack of echogenicity inside the cyst on the A-scan.
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Figure 3
Fluorescein angiography shows blocked fluorescence due to intravitreal cysticercosis on the early (A) and late phase (B). Fibrovascular tractional band shows hyperfluorescence and diffuse capillary leak is noted in the late phase. There was no other sign suggesting retinal vascular disease which can cause neovascular glaucoma.
Click for larger image


Figure 4
Optic disc shows enlarge cup-to-disc ratio to about 0.9 (A). Automated perimetry (Humphrey 30-2) shows arcuate scotoma in both upper and lower fields (B).
Click for larger image

References
1. Sharma T, Sinha S, Shah N, et al. Intraocular cysticercosis: clinical characteristics and visual outcome after vitreoretinal surgery. Ophthalmology 2003;110:996–1004.
2. Pushker N, Bajaj MS, Chandra M, Neena. Ocular and orbital cysticercosis. Acta Ophthalmol Scand 2001;79:408–413.
3. Chung YT. Two cases of cysticercosis in the vitreous body. J Korean Ophthalmol Soc 1973;14:383–386.
4. Choi CS, Rhee JW. A case of subretinal cysticercosis. J Korean Ophthalmol Soc 1966;7:101–103.
5. Sohn CK, Hong SH, Lee KC, Choe JK. A case of surgically extracted cysticercus cellulosae from the anterior chamber and three cases of subconjunctival cysticercosis cellulosae. J Korean Ophthalmol Soc 1967;8:25–29.
6. Ahn BH, Lee JH, Lee JH. Intraocular cysticercosis. J Korean Ophthalmol Soc 1975;16:209–215.
7. Seo MS, Woo JM, Park YG. Intravitreal cysticercosis. Korean J Ophthalmol 1996;10:55–59.
8. Kruger-Leite E, Jalkh AE, Quiroz H, Schepens CL. Intraocular cysticercosis. Am J Ophthalmol 1985;99:252–257.
9. Ratra D, Phogat C, Singh M, Choudhari NS. Intravitreal cysticercosis presenting as neovascular glaucoma. Indian J Ophthalmol 2010;58:70–73.
10. Gartner S, Henkind P. Neovascularization of the iris (rubeosis iridis). Surv Ophthalmol 1978;22:291–312.
11. Luger M, Stilma JS, Ringens PJ, van Baarlen J. In-toto removal of a subretinal Cysticercus cellulosae by pars plana vitrectomy. Br J Ophthalmol 1991;75:561–563.
12. Davidorf FH, Mouser JG, Derick RJ. Rapid improvement of rubeosis iridis from a single bevacizumab (Avastin) injection. Retina 2006;26:354–356.
13. Wakabayashi T, Oshima Y, Sakaguchi H, et al. Intravitreal bevacizumab to treat iris neovascularization and neovascular glaucoma secondary to ischemic retinal diseases in 41 consecutive cases. Ophthalmology 2008;115:1571–1580.