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DUSN

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The Uveitis Atlas
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Abstract

Diffuse unilateral subacute neuroretinitis (DUSN) was first described by Gass and was termed “unilateral wipe out syndrome” (Gass et al. 1978). He observed a subset of young adults and children with rapidly progressive visual loss accompanied by optic atrophy, retinal vascular attenuation, and pigmentary retinopathy in one eye. While reviewing serial photographs of these patients, he noted clusters of gray-white lesions that migrated to different areas of the fundus over time. The keen observer that he is, he found a small curvilinear glistening white structure approximately 400 microns in length with tapered ends in the vicinity of the active lesions. The white worm-like structure moved with the crops of gray-white lesions. This led him to describe DUSN, a condition that is characterized by migrating crops of creamy white retinal lesions caused by a moving tiny larva in the subretinal space.

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  • Akao N, Hayashi E, Sato H, Fujita K, Furuoka H. Diffuse retinochoroiditis due to Baylisascaris procyonis in Mongolian gerbils. J Parasitol. 2003;89:174–5.

    Article  CAS  PubMed  Google Scholar 

  • Anshu A, Chee SP. Diffuse unilateral subacute neuroretinitis. Int Ophthalmol. 2008;28:127–9.

    Article  PubMed  Google Scholar 

  • Carney MD, Combs JL. Diffuse unilateral subacute neuroretinitis. Br J Ophthalmol. 1991;75:633–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Casella AM, Farah ME, Souza EC, Belfort Jr R, Oguido AP. Retinal nerve fiber layer atrophy as relevant feature for diffuse unilateral subacute neuroretinitis (DUSN): case series. Arq Bras Oftalmol. 2010;73:182–5.

    Article  PubMed  Google Scholar 

  • Cortez R, Denny JP, Muci-Mendoza R, Ramirez G, Fuenmayor D, Jaffe GJ. Diffuse unilateral subacute neuroretinitis in Venezuela. Ophthalmology. 2005;112:2110–4.

    Article  PubMed  Google Scholar 

  • Cunha LP, Costa-Cunha LV, Souza EC, Monteiro ML. Intraretinal worm documented by optical coherence tomography in a patient with diffuse unilateral subacute neuroretinitis: case report. Arq Bras Oftalmol. 2010;73:462–3.

    Article  PubMed  Google Scholar 

  • de Amorim Garcia Filho CA, Gomes AH, de Amorim Garcia Soares AC, de Amorim Garcia CA. Clinical features of 121 patients with diffuse unilateral subacute neuroretinitis. Am J Ophthalmol. 2012;153:743–9.

    Article  PubMed  Google Scholar 

  • de Souza EC, Nakashima Y. Diffuse unilateral subacute neuroretinitis. Report of transvitreal surgical removal of a subretinal nematode. Ophthalmology. 1995;102:1183–6.

    Article  PubMed  Google Scholar 

  • de Souza EC, Abujamra S, Nakashima Y, Gass JD. Diffuse bilateral subacute neuroretinitis: first patient with documented nematodes in both eyes. Arch Ophthalmol. 1999;117:1349–51.

    Article  PubMed  Google Scholar 

  • Garcia CA, Gomes AH, Garcia Filho CA, Vianna RN. Early-stage diffuse unilateral subacute neuroretinitis: improvement of vision after photocoagulation of the worm. Eye. 2004;18:624–7.

    Article  PubMed  Google Scholar 

  • Garcia CA, Gomes AH, Vianna RN, Souza Filho JP, Garcia Filho CA, Orefice F. Late-stage diffuse unilateral subacute neuroretinitis: photocoagulation of the worm does not improve the visual acuity of affected patients. Int Ophthalmol. 2005;26:39–42.

    Article  PubMed  Google Scholar 

  • Garcia CA, Sabrosa NA, Gomes AB, Segundo Pde S, Garcia Filho CA, Sabrosa AS. Diffuse unilateral subacute neuroretinitis – DUSN. Int Ophthalmol Clin. 2008;48:119–29.

    Article  PubMed  Google Scholar 

  • Gass JD. Acute herpetic thrombotic retinal angiitis and necrotizing neuroretinitis (“acute retinal necrosis syndrome”). Trans New Orleans Acad Ophthalmol. 1983;31:97–107.

    CAS  PubMed  Google Scholar 

  • Gass JD, Braunstein RA. Further observations concerning the diffuse unilateral subacute neuroretinitis syndrome. Arch Ophthalmol. 1983;101:1689–97.

    Article  CAS  PubMed  Google Scholar 

  • Gass JD, Scelfo R. Diffuse unilateral subacute neuroretinitis. J R Soc Med. 1978;71:95–111.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gass JD, Gilbert Jr WR, Guerry RK, Scelfo R. Diffuse unilateral subacute neuroretinitis. Ophthalmology. 1978;85:521–45.

    Article  CAS  PubMed  Google Scholar 

  • Goldberg N, Bhatnagar P. Letter to the editor. Diffuse unilateral subacute neuroretinitis (DUSN). Ocul Immunol Inflamm. 2012;20:139–42.

    Article  PubMed  Google Scholar 

  • Goldberg MA, Kazacos KR, Boyce WM, Ai E, Katz B. Diffuse unilateral subacute neuroretinitis. Morphometric, serologic, and epidemiologic support for Baylisascaris as a causative agent. Ophthalmology. 1993;100:1695–701.

    Article  CAS  PubMed  Google Scholar 

  • Gomes AH, Garcia CA, Segundo Pde S, Garcia Filho CA, Garcia AC. Optic coherence tomography in a patient with diffuse unilateral subacute neuroretinitis. Arq Bras Oftalmol. 2009;72:185–8.

    Article  PubMed  Google Scholar 

  • Harto MA, Rodriguez-Salvador V, Avino JA, Duch-Samper AM, Menezo JL. Diffuse unilateral subacute neuroretinitis in Europe. Eur J Ophthalmol. 1999;9:58–62.

    CAS  PubMed  Google Scholar 

  • Kazacos KR, Raymond LA, Kazacos EA, Vestre WA. The raccoon ascarid. A probable cause of human ocular larva migrans. Ophthalmology. 1985;92:1735–44.

    Article  CAS  PubMed  Google Scholar 

  • Matsumoto BT, Adelberg DA, Del Priore LV. Transretinal membrane formation in diffuse unilateral subacute neuroretinitis. Retina. 1995;15:146–9.

    Article  CAS  PubMed  Google Scholar 

  • Mets MB, Noble AG, Basti S, et al. Eye findings of diffuse unilateral subacute neuroretinitis and multiple choroidal infiltrates associated with neural larva migrans due to Baylisascaris procyonis. Am J Ophthalmol. 2003;135:888–90.

    Article  PubMed  Google Scholar 

  • Naumann GO, Knorr HL. DUSN occurs in Europe. Ophthalmology. 1994;101:971–2.

    Article  CAS  PubMed  Google Scholar 

  • Sabrosa NA, Zajdenweber M. Nematode infections of the eye: toxocariasis, onchocerciasis, diffuse unilateral subacute neuroretinitis, and cysticercosis. Ophthalmol Clin N Am. 2002;15:351–6.

    Article  Google Scholar 

  • Saffra NA, Perlman JE, Desai RU, et al. Baylisascaris procyonis induced diffuse unilateral subacute neuroretinitis in New York City. J Neuro-Oncol. 2010;1(6):1–4.

    Google Scholar 

  • Salvanet-Bouccara A, Troussier H. Diffuse unilateral subacute neuroretinitis. Apropos of a case. J Fr Ophtalmol. 1987;10:667–72.

    CAS  PubMed  Google Scholar 

  • Souza EC, Casella AM, Nakashima Y, Monteiro ML. Clinical features and outcomes of patients with diffuse unilateral subacute neuroretinitis treated with oral albendazole. Am J Ophthalmol. 2005;140:437–45.

    Article  CAS  PubMed  Google Scholar 

  • Tarantola RM, Elkins KA, Kay CN, Folk JC. Photoreceptor recovery following laser photocoagulation and albendazole in diffuse unilateral subacute neuroretinitis. Arch Ophthalmol. 2011;129:669–71.

    Article  PubMed  Google Scholar 

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Patel, S., Agarwal, A. (2018). DUSN. In: Gupta, V., Nguyen, Q., LeHoang, P., Herbort Jr., C. (eds) The Uveitis Atlas. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2506-5_48-1

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  • DOI: https://doi.org/10.1007/978-81-322-2506-5_48-1

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  • Print ISBN: 978-81-322-2506-5

  • Online ISBN: 978-81-322-2506-5

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