|Year : 2020 | Volume
| Issue : 8 | Page : 1654-1655
A rare case of intraocular communicating cysticercosis
R S Keerthhi Dhevi, V Anusha, M Prabhu Shanker, G Geetha
Sankara Eye Hospital, Coimbatore, Tamil Nadu, India
|Date of Submission||05-Feb-2019|
|Date of Acceptance||13-Feb-2020|
|Date of Web Publication||24-Jul-2020|
Dr. V Anusha
Consultant, Vitreo Retina, Sankara Eye Hospital, Sathy Road, Sivanandapuram, Coimbatore - 35, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Keywords: Communicating cysticercosis, chandelier assisted vitrectomy, hyaloid tunnel
|How to cite this article:|
Dhevi R S, Anusha V, Shanker M P, Geetha G. A rare case of intraocular communicating cysticercosis. Indian J Ophthalmol 2020;68:1654-5
|How to cite this URL:|
Dhevi R S, Anusha V, Shanker M P, Geetha G. A rare case of intraocular communicating cysticercosis. Indian J Ophthalmol [serial online] 2020 [cited 2020 Aug 15];68:1654-5. Available from: http://www.ijo.in/text.asp?2020/68/8/1654/290405
A 59-year-old female presented with gradual diminution of vision in the left eye for 3 months associated with pain and redness. The best-corrected visual acuity (BCVA) in the right eye was 20/20 and counting fingers close to face in the left eye. The examination of the right eye was unremarkable. The left eye showed a sluggishly reacting pupil, partial posterior vitreous detachment (PVD) and two well-defined overlapping translucent cysts just below the inferior arcade, the larger one in the retro-hyaloid space demonstrating the typical undulating movement and the smaller one in the sub retinal space harboring the scolex [Figure 1]. CT brain showed features suggestive of neuro-cysticercosis.
|Figure 1: (a) Fundus photo of the left eye revealing two well defined overlapping translucent cysts, one large in the retro-hyaloid space (b) and one small in the sub retinal space (c) just below the inferior arcade|
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After obtaining neurologist opinion and initiation of oral steroids, through 25-gauge pars plana vitrectomy, the retro-hyaloid space was entered through the area of partial PVD. The cyst capsule was firmly adherent to the hyaloid, which was gently separated using a soft-tipped cannula when it was still found adherent to the underlying structures. After meticulous dissection, this cyst was found communicating to the sub retinal cyst through the posterior hyaloid [Figure 2]a. Chandelier-assisted bimanual dissection was then performed to open up the 'hyaloid tunnel' [Figure 2]b that enveloped its connection to the sub retinal component of the cyst, which was subsequently teased out into the vitreous cavity in toto with passive suction revealing its dumbbell shape [Figure 2]c. It was then removed completely with a high-speed vitrectomy cutter. The bed of the cyst with surrounding fibrosis was lasered. At one-week follow up, her BCVA had improved to 20/120 and her retina was attached [Figure 3]. Anticonvulsant and antiparasitic therapy were initiated.
|Figure 2: (a) Intra operative photo showing the communicating cyst in situ. (b and c) showing the ‘hyaloid tunnel’ (black arrow) and the dumbbell shaped cyst in toto|
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|Figure 3: (a) Post operative fundus photo at 2 weeks follow up. (b and c) demonstrating the bed of the cyst|
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| Discussion|| |
Chandelier-assisted bimanual dissection helps achieve meticulous dissection and isolation of the cyst in toto prior to its removal with a high-speed vitreous cutter, thus ensuring its complete removal and good post operative visual recovery.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Gemolotto G. A contribution to surgical treatment of intraocular cysticercosis. Arch Ophthalmol 1955;59:365-8.
Kumar A, Verma L, Khosla PK, Tewari HK, Jha SN. Communicating intravitreal cysticercosis. Ophthalmic Surgery, Lasers and Imaging Retina 1989;20:424-6.
Astir S, Shroff DN, Gupta C, Shroff CM, Saha I, Dutta R. Bimanual 25-gauge chandelier technique for direct perfluorocarbon liquid-silicone oil exchange in retinal detachments associated with giant retinal tear. Indian J Ophthalmol 2018;66:1849.
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[Figure 1], [Figure 2], [Figure 3]