This healthy 29YO female was referred for asymptomatic bilateral retinal findings. Vision was 20/40 OU.
Optos color RG imaging shows a large area of variably atrophic and fibrotic subretinal scarring inferotemporally OD, with a smaller area of scarring temporally OS. The scarring in her left eye has a more triangular appearance. Toxocara canis ELISA bloodwork was positive.
Learning Points:
Toxocariasis is a rare infection caused by the toxocara canis roundworm, which matures in the dog intestine. The eggs are passed in the stool, which can then be ingested when young children come into contact with infected sand or dirt and then touch their mouth. The ingested egg matures into a larva, which enters the systemic circulation from the intestine and can migrate into the eye. The death of the organism can cause variable findings, including endophthalmitis (typically a completely white, quiet eye), posterior granuloma, or peripheral granuloma.
Most commonly in our experience, they present as a triangular-shaped area of vitreous base organization/scarring, with a fold of retina extending more posteriorly. Since there is usually a single larva, the eye findings are almost always unilateral. Our case is therefore quite unusual in its bilaterality.
