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To Study Presentation of Ocular Cysticercosis and Evaluate Its Demographic Data, Diagnosis, Treatment and Outcome in a Hill Population of Northern India

Received: 1 June 2021    Accepted: 15 June 2021    Published: 22 June 2021
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Abstract

Aim: To study presentation of ocular cysticercosis and to evaluate its demographic data, diagnosis, treatment and outcome in hill population of Northern India. Materials and methods: This is a retrospective study carried out in Dehradun, Uttarakhand in a tertiary eye care hospital over 4 years from 2016-2020. The study involved 38 patients who presented with unilateral eye disease and were diagnosed to have ocular or adenexal cysticercosis. We analysed retrospectively their geographical data, clinical presentation, serology, imaging, response to treatment and clinical outcome. Results: Age of patients ranged from 16-54 years. Male to female ratio was 1:3.75. Total no. of eyes affected were 38. All were unilateral presentation. 30 eyes (78.94%) presented with extraocular cysticercosis and 8 eyes (21.05%) with intraocular cysticercosis. 27 of the patients (71.05%) were from lower socioeconomic status with poor hygiene and sanitation conditions. 32 (89.21%) patients gave history of association with non-vegetarian diet. Extraocular cysticercosis group had restriction of ocular motility as most prevalent presentation seen in 16 eyes (53.33%) and proptosis as the most prevalent sign seen in 17 eyes (56.66%). Cyst prevalence was most frequently detected in superior rectus muscle seen in 14 eyes (53.84%). Intraocular cysticercosis group had blurring of vision as the most prevalent presenting symptom in 8 eyes (100.0%). Panuveitis in 6 eyes (75%) and presence of subretinal cyst in 4 eyes (50%) was the most prevalent sign seen in intraocular cysticercosis group. Enzyme linked immunosorbent assay test confirmed serology in 35 cases (92.10%). The USG B-scan detected presence of scolex in 36 eyes (94.73%). Magnetic resonance imaging (MRI) confirmed deep seated extraocular cysticercosis lesions and neurocysticercosis (NCC) undetected by computerized tomography (CT). CT was diagnostic for NCC in 5 cases (13.15%). Oral Albendazole and prednisolone were successful in management of extraocular cysticercosis. Intraocular cysticercosis was treated well with pars plana vitrectomy surgery with good visual recovery. Conclusion: Extraocular cysticercosis was more prevalent than intraocular cysticercosis. Early diagnosis and treatment made a difference in final outcome of the two groups. Imaging studies of orbital B-scan ultrasonography (USG B scan), CT and MRI with immune serological test of enzyme linked immunosorbet assay (ELISA) and Western blot for anticysticercus antibodies helped in confirming the diagnosis. Extraocular cysticercosis can be managed well medically with good clinical outcome. Intraocular cysticercosisis is best treated surgically. Safer and modern vitreoretinal surgical techniques promise good surgical outcome and visual recovery. Timely intervention and frequent postoperative follow up would help in keeping a watch on development of complications and maintenance of good vision.

Published in International Journal of Ophthalmology & Visual Science (Volume 6, Issue 2)
DOI 10.11648/j.ijovs.20210602.21
Page(s) 128-143
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Albendazole, Cysticercosis, Corticosteroids, ELISA, Magnetic Resonance Imaging, USG Bscan, Parsplana Vitrectomy

References
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    Deepesh Arora, Anuj Sharma, Ratish Raman, Ankit Parasher, Chinky Sharma, et al. (2021). To Study Presentation of Ocular Cysticercosis and Evaluate Its Demographic Data, Diagnosis, Treatment and Outcome in a Hill Population of Northern India. International Journal of Ophthalmology & Visual Science, 6(2), 128-143. https://doi.org/10.11648/j.ijovs.20210602.21

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    Deepesh Arora; Anuj Sharma; Ratish Raman; Ankit Parasher; Chinky Sharma, et al. To Study Presentation of Ocular Cysticercosis and Evaluate Its Demographic Data, Diagnosis, Treatment and Outcome in a Hill Population of Northern India. Int. J. Ophthalmol. Vis. Sci. 2021, 6(2), 128-143. doi: 10.11648/j.ijovs.20210602.21

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    AMA Style

    Deepesh Arora, Anuj Sharma, Ratish Raman, Ankit Parasher, Chinky Sharma, et al. To Study Presentation of Ocular Cysticercosis and Evaluate Its Demographic Data, Diagnosis, Treatment and Outcome in a Hill Population of Northern India. Int J Ophthalmol Vis Sci. 2021;6(2):128-143. doi: 10.11648/j.ijovs.20210602.21

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  • @article{10.11648/j.ijovs.20210602.21,
      author = {Deepesh Arora and Anuj Sharma and Ratish Raman and Ankit Parasher and Chinky Sharma and Devesh Sharma and Bhawna Tiwari and Himanshu Arora and Abhishek Kumar and Kanika Gupta and Niyaaz Ahmad and Sulekha Nautiyal and Surbhi Verma and Deepak Anthwal and Dinesh Sharma},
      title = {To Study Presentation of Ocular Cysticercosis and Evaluate Its Demographic Data, Diagnosis, Treatment and Outcome in a Hill Population of Northern India},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {6},
      number = {2},
      pages = {128-143},
      doi = {10.11648/j.ijovs.20210602.21},
      url = {https://doi.org/10.11648/j.ijovs.20210602.21},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210602.21},
      abstract = {Aim: To study presentation of ocular cysticercosis and to evaluate its demographic data, diagnosis, treatment and outcome in hill population of Northern India. Materials and methods: This is a retrospective study carried out in Dehradun, Uttarakhand in a tertiary eye care hospital over 4 years from 2016-2020. The study involved 38 patients who presented with unilateral eye disease and were diagnosed to have ocular or adenexal cysticercosis. We analysed retrospectively their geographical data, clinical presentation, serology, imaging, response to treatment and clinical outcome. Results: Age of patients ranged from 16-54 years. Male to female ratio was 1:3.75. Total no. of eyes affected were 38. All were unilateral presentation. 30 eyes (78.94%) presented with extraocular cysticercosis and 8 eyes (21.05%) with intraocular cysticercosis. 27 of the patients (71.05%) were from lower socioeconomic status with poor hygiene and sanitation conditions. 32 (89.21%) patients gave history of association with non-vegetarian diet. Extraocular cysticercosis group had restriction of ocular motility as most prevalent presentation seen in 16 eyes (53.33%) and proptosis as the most prevalent sign seen in 17 eyes (56.66%). Cyst prevalence was most frequently detected in superior rectus muscle seen in 14 eyes (53.84%). Intraocular cysticercosis group had blurring of vision as the most prevalent presenting symptom in 8 eyes (100.0%). Panuveitis in 6 eyes (75%) and presence of subretinal cyst in 4 eyes (50%) was the most prevalent sign seen in intraocular cysticercosis group. Enzyme linked immunosorbent assay test confirmed serology in 35 cases (92.10%). The USG B-scan detected presence of scolex in 36 eyes (94.73%). Magnetic resonance imaging (MRI) confirmed deep seated extraocular cysticercosis lesions and neurocysticercosis (NCC) undetected by computerized tomography (CT). CT was diagnostic for NCC in 5 cases (13.15%). Oral Albendazole and prednisolone were successful in management of extraocular cysticercosis. Intraocular cysticercosis was treated well with pars plana vitrectomy surgery with good visual recovery. Conclusion: Extraocular cysticercosis was more prevalent than intraocular cysticercosis. Early diagnosis and treatment made a difference in final outcome of the two groups. Imaging studies of orbital B-scan ultrasonography (USG B scan), CT and MRI with immune serological test of enzyme linked immunosorbet assay (ELISA) and Western blot for anticysticercus antibodies helped in confirming the diagnosis. Extraocular cysticercosis can be managed well medically with good clinical outcome. Intraocular cysticercosisis is best treated surgically. Safer and modern vitreoretinal surgical techniques promise good surgical outcome and visual recovery. Timely intervention and frequent postoperative follow up would help in keeping a watch on development of complications and maintenance of good vision.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - To Study Presentation of Ocular Cysticercosis and Evaluate Its Demographic Data, Diagnosis, Treatment and Outcome in a Hill Population of Northern India
    AU  - Deepesh Arora
    AU  - Anuj Sharma
    AU  - Ratish Raman
    AU  - Ankit Parasher
    AU  - Chinky Sharma
    AU  - Devesh Sharma
    AU  - Bhawna Tiwari
    AU  - Himanshu Arora
    AU  - Abhishek Kumar
    AU  - Kanika Gupta
    AU  - Niyaaz Ahmad
    AU  - Sulekha Nautiyal
    AU  - Surbhi Verma
    AU  - Deepak Anthwal
    AU  - Dinesh Sharma
    Y1  - 2021/06/22
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijovs.20210602.21
    DO  - 10.11648/j.ijovs.20210602.21
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
    SP  - 128
    EP  - 143
    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20210602.21
    AB  - Aim: To study presentation of ocular cysticercosis and to evaluate its demographic data, diagnosis, treatment and outcome in hill population of Northern India. Materials and methods: This is a retrospective study carried out in Dehradun, Uttarakhand in a tertiary eye care hospital over 4 years from 2016-2020. The study involved 38 patients who presented with unilateral eye disease and were diagnosed to have ocular or adenexal cysticercosis. We analysed retrospectively their geographical data, clinical presentation, serology, imaging, response to treatment and clinical outcome. Results: Age of patients ranged from 16-54 years. Male to female ratio was 1:3.75. Total no. of eyes affected were 38. All were unilateral presentation. 30 eyes (78.94%) presented with extraocular cysticercosis and 8 eyes (21.05%) with intraocular cysticercosis. 27 of the patients (71.05%) were from lower socioeconomic status with poor hygiene and sanitation conditions. 32 (89.21%) patients gave history of association with non-vegetarian diet. Extraocular cysticercosis group had restriction of ocular motility as most prevalent presentation seen in 16 eyes (53.33%) and proptosis as the most prevalent sign seen in 17 eyes (56.66%). Cyst prevalence was most frequently detected in superior rectus muscle seen in 14 eyes (53.84%). Intraocular cysticercosis group had blurring of vision as the most prevalent presenting symptom in 8 eyes (100.0%). Panuveitis in 6 eyes (75%) and presence of subretinal cyst in 4 eyes (50%) was the most prevalent sign seen in intraocular cysticercosis group. Enzyme linked immunosorbent assay test confirmed serology in 35 cases (92.10%). The USG B-scan detected presence of scolex in 36 eyes (94.73%). Magnetic resonance imaging (MRI) confirmed deep seated extraocular cysticercosis lesions and neurocysticercosis (NCC) undetected by computerized tomography (CT). CT was diagnostic for NCC in 5 cases (13.15%). Oral Albendazole and prednisolone were successful in management of extraocular cysticercosis. Intraocular cysticercosis was treated well with pars plana vitrectomy surgery with good visual recovery. Conclusion: Extraocular cysticercosis was more prevalent than intraocular cysticercosis. Early diagnosis and treatment made a difference in final outcome of the two groups. Imaging studies of orbital B-scan ultrasonography (USG B scan), CT and MRI with immune serological test of enzyme linked immunosorbet assay (ELISA) and Western blot for anticysticercus antibodies helped in confirming the diagnosis. Extraocular cysticercosis can be managed well medically with good clinical outcome. Intraocular cysticercosisis is best treated surgically. Safer and modern vitreoretinal surgical techniques promise good surgical outcome and visual recovery. Timely intervention and frequent postoperative follow up would help in keeping a watch on development of complications and maintenance of good vision.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Vitreo-Retina, Amritsar Eye Clinic, Dehradun, India

  • Department of Vitreo-Retina, Amritsar Eye Clinic, Dehradun, India

  • Department of Radiodiagnosis, Teerthankar Mahaveer Medical College and Research Centre, Moradabad, India

  • Department of Radiodiagnosis, Parashers Pathology and Imaging Centre, Dehradun, India

  • Department of General Medicine, Teerthankar Mahaveer Medical College and Research Centre, Moradabad, India

  • Department of Cornea and Refractive Surgery, Amritsar Eye clinic, Dehradun, India

  • Department of Oculoplasty and Reconstructive Surgery, Amritsar Eye clinic, Dehradun, India

  • Department of Glaucoma, Amritsar Eye clinic, Dehradun, India

  • Department of Cataract and Microsurgery, Amritsar Eye clinic, Dehradun, India

  • Department of Paediatric Ophthalmology, Amritsar Eye clinic, Dehradun, India

  • Department of Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India

  • Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India

  • Department of Cornea and Refractive Surgery, Sadguru Netra Chikitsalaya, Chirakoot, India

  • Department of Retina-Vitreous, Aravind Eye Hospital, Coimbatore, India

  • Department of Cataract and Refractive Surgery, Amritsar Eye clinic, Dehradun, India

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