•Ophthalmic Cysticercosis
by H. Ronnie Nelson II
by H. Ronnie Nelson II
What is ophthalmic cysticercosis?
•An infection in and around the
ocular organs caused
by Taenia solium (the pork tapeworm). The Infection occurs when the tapeworm larvae
enter the body and form cysticerci. When cysticerci are found in the brain, the
condition is called neurocysticercosis
Scientific
Classification
•Kingdom:
Animalia
•Phylum:
Plathelminthes
•Class:
Cestoda
•Order:
Cyclophyllidea
•Family:
Taeniidae
•Genus:
Taenia
•Species:
Taenia Solium
Transmission
to humans
Humans are the intermediate hosts for T solium, and pigs are the definitive
hosts. A tapeworm larval cyst (cysticercus) is ingested with poorly-cooked
infected pork. The larva escapes the cyst and passes to the small intestine,
where it attaches to the mucosa with scolex suckers. Egg-containing proglottids develop as the worm matures in 3-4
months.
The adult worm may live in the small
intestine for as long as 25
years without
symptoms. When the primary larvae (oncospheres) penetrate the intestinal mucosa,
the Larvae enters into the circulatory system spreading to the Neural,
muscular, and ocular tissues of the human body.
•Symptoms
•Nausea
•Week Muscles
•Loss of Weight
•Malnutrition
•Abdominal Pain
•Passing worm sections in stool
Ophthalmic Cysticercosis can affect ALL ocular Tissue including:
•Vitreous cavity
•Subretinal tissue
•Conjunctiva
•Extraocular muscles
•Optic Nerve
Damage to these areas can result in
the following:
•Cataract formation
•Iritis
•Severe Headache
•Strabismus
•Diplopia
•Severe redness
•Proptosis
Facts about Ophthalmic Cysticercosis…
•A LIVE cyst may be freely mobile inside
the anterior chamber or attached to an ocular structure surrounded in a bed of
inflammation.
•Cyst death causes the release of
TOXIC products also resulting in severe inflammation.
•Cases with intense inflammation may
prevent the cyst from being clinically visualized by ocular and neural imaging
technology.
•Cysticercosis affects an estimated 50
million people
worldwide.
• Ocular cysticercosis is endemic in tropical areas, such
as sub-Saharan Africa, India, and East Asia. Other endemic areas include Mexico
and Latin America.
•There is a correlation between new
diagnosed cases in the U.S. and immigration increases from endemic areas.
•An estimated 1000 new cases per
year are diagnosed in the United States.
•There is no statistical evidence
showing diagnosed cases being related to race, sex, or specific to one eye.
•Ocular Cysticercosis is more commonly reported younger
age groups.
Treatment
•Surgical removal is required in individuals with intraocular
cysts.
•Deep orbital dissection in conjunction
with difficulty in completely excising/removing the cyst because of the
surrounding inflammatory response increase the chances of postoperative
complications.
•Cysts deep within the orbit are
best treated conservatively with a 4-week regimen of oral albendazole (Benzamidazole) in conjunction with oral steroids/corticosteroids in a tapering dose over a 1-month period.
•Resolution of the cyst may take
from a few days to months depending on the density of the surrounding
inflammation. Based on the individual’s response to medical therapy, another
course of medication may be required.