J Korean Ophthalmol Soc.  2013 Oct;54(10):1610-1613.

A Case of Intravitreal Cysticercosis with Neovascular Glaucoma

• Ko JS
• Kim GA
• Shin JY
• Byeon SH

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.

Keyword

Intravitreal cysticercosis; Neovascular glaucoma

MeSH Terms

Adult
Anterior Chamber
Antibodies, Monoclonal, Humanized
Cysticercosis*
Eye
Female
Fluorescein Angiography
Follow-Up Studies
Glaucoma, Neovascular*
Humans
Intraocular Pressure
Iris
Manometry
Philippines
Recurrence
Retinaldehyde
Traction
Uveitis, Posterior
Vascular Diseases
Visual Acuity
Visual Fields
Vitrectomy
Bevacizumab
Antibodies, Monoclonal, Humanized
Retinaldehyde

Figure

• 

  Figure 1. Intravitreal cystic lesion is noted at the superonasal periphery. (A) Fractional 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.

• 

  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.

• 

  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).

Reference

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