Intraocular dirofilariasis: Surgical approaches, features of the clinical course (clinical case)

Abstract

The  aim. To  present a  clinical case of  surgical treatment of  parasitic invasion of the vitreous body caused by dirofilaria.Material and methods. One patient with intraocular dirofilariasis got operated underwent surgical treatment including vitrectomy, phacoemulsification with implantation of an intraocular lens. At the stage of vitrectomy, a whole helminth was removed from the vitreal cavity using collet tweezers for subsequent typing. The uncorrected visual acuity of the right eye at the time of treatment was 0.4, of the left eye – 0.45.Results. The  postoperative period had no  signs of  an  active inflammatory reaction. 4 months after surgical treatment, at a follow-up visit, visual acuity of the left eye reached 1.0. According to the parasitological study, a female Dirofilaria repens was identified. In the postoperative period, the areas of pronounced chorioretinal atrophy in the peripheral parts of the retina were visualized, which may be a consequence of mechanical contact of the parasite or the toxic effects of its metabolic products.Conclusion. This  clinical example demonstrates the  possibility of  infection with the  ocular form of  dirofilariasis in  a  region that is  atypical for  the  presence of this helminth. Despite the positive outcome of the disease, in the presented patient, the long-term presence of the parasite in the vitreal cavity led to the formation of chorioretinal atrophy in the peripheral retina, which confirms the need for timely diagnosis and surgical treatment.