Clinical Course and Optical Coherence Tomography of Ocular Angiostrongyliasis: A Case Report

PURPOSE: To report the clinical course and optical coherence tomography (OCT) findings of ocular angiostrongyliasis. METHODS: A 36-year-old female with a history of ingesting regular raw freshwater shrimp and other raw food presented with acute unilateral painless visual loss in the right eye. Her right eye’s best-corrected visual acuity (BCVA) was 1 ft of the count finger. Fundus examination showed vitritis, generalized retinal pigment epithelial alteration, and a moving roundworm in the vitreous at the 6 o’clock position. Macular OCT of her right eye showed thinning of the retina, loss of the external limiting membrane and ellipsoid zone, subretinal hyper-reflective material clumping, and hyper-reflective foci at the superficial choroidal layer. RESULTS: The patient was administered oral and topical prednisolone. The roundworm, identified as Angiostrongylus cantonensis, was wholly extracted from the vitreous using a 23G sclerotomy port and pars plana vitrectomy. The final BCVA was 1 ft of the count finger. CONCLUSION: This case report describes an infrequent presentation and illustrates the clinical course and OCT findings of ocular angiostrongyliasis.