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.
Suggested Reading
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.
Anshu A, Chee SP. Diffuse unilateral subacute neuroretinitis. Int Ophthalmol. 2008;28:127–9.
Carney MD, Combs JL. Diffuse unilateral subacute neuroretinitis. Br J Ophthalmol. 1991;75:633–5.
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.
Cortez R, Denny JP, Muci-Mendoza R, Ramirez G, Fuenmayor D, Jaffe GJ. Diffuse unilateral subacute neuroretinitis in Venezuela. Ophthalmology. 2005;112:2110–4.
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.
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.
de Souza EC, Nakashima Y. Diffuse unilateral subacute neuroretinitis. Report of transvitreal surgical removal of a subretinal nematode. Ophthalmology. 1995;102:1183–6.
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.
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.
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.
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.
Gass JD. Acute herpetic thrombotic retinal angiitis and necrotizing neuroretinitis (“acute retinal necrosis syndrome”). Trans New Orleans Acad Ophthalmol. 1983;31:97–107.
Gass JD, Braunstein RA. Further observations concerning the diffuse unilateral subacute neuroretinitis syndrome. Arch Ophthalmol. 1983;101:1689–97.
Gass JD, Scelfo R. Diffuse unilateral subacute neuroretinitis. J R Soc Med. 1978;71:95–111.
Gass JD, Gilbert Jr WR, Guerry RK, Scelfo R. Diffuse unilateral subacute neuroretinitis. Ophthalmology. 1978;85:521–45.
Goldberg N, Bhatnagar P. Letter to the editor. Diffuse unilateral subacute neuroretinitis (DUSN). Ocul Immunol Inflamm. 2012;20:139–42.
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.
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.
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.
Kazacos KR, Raymond LA, Kazacos EA, Vestre WA. The raccoon ascarid. A probable cause of human ocular larva migrans. Ophthalmology. 1985;92:1735–44.
Matsumoto BT, Adelberg DA, Del Priore LV. Transretinal membrane formation in diffuse unilateral subacute neuroretinitis. Retina. 1995;15:146–9.
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.
Naumann GO, Knorr HL. DUSN occurs in Europe. Ophthalmology. 1994;101:971–2.
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.
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.
Salvanet-Bouccara A, Troussier H. Diffuse unilateral subacute neuroretinitis. Apropos of a case. J Fr Ophtalmol. 1987;10:667–72.
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.
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.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer (India) Pvt. Ltd.
About this entry
Cite this entry
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
Download citation
DOI: https://doi.org/10.1007/978-81-322-2506-5_48-1
Received:
Accepted:
Published:
Publisher Name: Springer, New Delhi
Print ISBN: 978-81-322-2506-5
Online ISBN: 978-81-322-2506-5
eBook Packages: Springer Reference MedicineReference Module Medicine