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Vitreoretinal Surgery in Rare Conditions
Published in Pradeep Venkatesh, Handbook of Vitreoretinal Surgery, 2023
Manifestations of intraocular cysticercosis include sense of foreign body within the visual field, either fixed or floating, defective visual function, and sometimes features of ocular inflammation [pain, redness]. It is infrequent to find more than one cyst and bilateral cysts. The most frequent intraocular location is within the posterior chamber [vitreous cavity and subretinal space]. Concurrent findings include signs of anterior chamber inflammation or panuveitis, inflamed iris vessels, posterior synechiae, cataract, cyclitic membrane, dense vitreous inflammatory membranes [that may be vascularized and hence mistaken for the retina], inflammatory deposits over the hyaloid, focal area of dense scarring [site through which the cyst has entered the subretinal space or vitreous cavity], and retinal detachment. The natural history of eyes with intraocular cysticercosis is eventual phthisis, and hence there is a need for early diagnosis and management. In doubtful cases wherein the cyst and its scolex cannot be discerned on ophthalmoscopic evaluation, USG of the eyeball is an immensely helpful and mandatory investigation.
Infectious Optic Neuropathies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Imran Rizvi, Ravindra Kumar Garg
Neurocysticercosis is a common parasitic infection of the brain. In many cases of neurocysticercosis, optic nerve may be involved. Papilledema, chiasmal and retrochiasmal lesions can cause optic nerve damage. Optic nerve may get compressed with enlarging hydrocephalus and raised intracranial pressure.63 Patients with orbital cysticercosis present with eye pain, proptosis and vision loss. Diagnosis of orbital or ocular cysticercosis is made by orbital sonography. Frequently, orbital neurocysticercosis is part of disseminated neurocysticercosis. Demonstration of scolex within the cysts is pathognomonic of neurocysticercosis. Currently, surgical removal of ocular cysticercosis is the treatment of choice.64 In some reports, albendazole and corticosteroids were found effective.65
Surveillance and Control Programs for Cestode Diseases
Published in Max J. Miller, E. J. Love, Parasitic Diseases: Treatment and Control, 2020
Although not easy to estimate, the human health impact of T. solium cysticercosis includes hospital and surgical costs, complete or partial disability loss to work force, and deaths. Of neurocysticercosis patients, 50% require more than one hospitalization and more than one surgical intervention, and more than half of surgical patients do not recover sufficiently to return to work.34 In Mexico, the costs per patient for medical care in 1982 was estimated at U.S.$2,173.35 These authors went on to calculate the total costs and losses associated with human cysticercosis in Mexico as of the order of U.S.$255,000,000/year. Despite the high visibility in Mexico of cysticercosis as a clinical problem, very little has been reported on the epidemiological aspects of this disease. Surveillance systems are entirely inadequate, and clinical cases diagnosed and reported from Mexico City and a few other large cities greatly skew the apparent geographic distribution of the disease.40 Community-based duties documenting the health impact and the risk factors for transmission have not been carried out. Controversy exists concerning the importance of socioeconomic variables and even relative prevalence in urban and rural areas.27,41
Diagnostic and management strategies of ocular cysticercosis: current perspectives
Published in Expert Review of Ophthalmology, 2020
Cystercosis is a cestode infection that is an important problem in tropical medicine [1–3]. This is a form of Taenia species infection. The human cysticercosis is an accidental dead ended infection caused by pork tapeworm (Taenia solium). The disease is caused by larval cysts of the tapeworm. The two main ways that the patients can acquire this infection are ingestion of tapeworm eggs through a fecal-oral transmission or autoinfection. Basically, human is a definitive host for adult parasite and pig plays role as an intermediate hosts harboring parasitic larva. Accidentally, human might act as an intermediate host and result in cysticercosis. The heteroinfection due to intake of contaminated food or water with the parasitic eggs, external autoinfection by ingestion ova of the existing parasite or internal autoinfection by retrograde peristalsis that pushes proglottids bearing eggs from intestine directly to stomach are the three ways that a human might become an intermediate host and further develops cysticercosis. The disease is strongly related to poor hygiene and common in areas with poor background sanitation.
Analysis of Clinical Profile, Investigation, and Management of Ocular Cysticercosis Seen at a Tertiary Referral Centre
Published in Ocular Immunology and Inflammation, 2018
Amongst the IC, posterior segment cysticercosis is reported to be more common than anterior segment cysticercosis,4,7,22,23 and a similar observation was made in our study too. We found that the cyst located mostly in the vitreous (56.6%) followed by subretinal cysts (36.6%) and only 6.6% of cysts in anterior chamber. There are few reports in the literature describing anterior chamber cysticercosis.24,25 The treatment of anterior chamber cysticercosis is essentially surgical. The different modalities described in the literature have been used to remove the cyst including paracentesis, extraction with capsule forceps, cryo-extraction, erysiphake extraction, and viscoexpression.15,36 In our series, we had two patients with anterior chamber cysticercosis who presented with anterior uveitis, fibrinous iridocyclitis with secondary glaucoma. The anterior uveitis could be due to the toxin and heterologous protein leakage through the vesicle wall of the cysticercosis in the vesicular stage of its development.25,37 Viscoexpression was done for both the cases, which is considered to be the best technique for surgical management of anterior segment cysticercosis.38,39 The inflammation resolved after the viscoexpression of the cysts. Postoperatively, vision improved to 20/20, the anterior segment was quiet, with normal intraocular pressure in both cases.
Neurocysticercosis: the good, the bad, and the missing
Published in Expert Review of Neurotherapeutics, 2018
Arturo Carpio, Agnès Fleury, Matthew L. Romo, Ronaldo Abraham
Despite being considered a potentially eradicable disease, cysticercosis remains a challenge. It could be argued that its occurrence is unacceptable. The objective of the WHO to scale up interventions for control and elimination of T. solium in selected countries in Africa, Asia, and Latin America by 2020 may lead to a major change in the panorama. Particularly, preventive procedures including basic sanitation and strict food hygiene control must be enhanced. Promotion of the habit of using sanitary facilities and rearing pigs in complete separation from human waste are mandatory. National programs must be encouraged in which, particularly, the utilization of cheaper and effective pig vaccines should be promoted.