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Lúcio R. Moraes, MD; Arnaldo P. Cialdini, MD; Marcos P. Avila, MD, PhD; Ann E. Elsner, PhD

Arch Ophthalmol. 2002;120:135-138.

Objective  To describe use of the scanning laser ophthalmoscope (SLO) to identify live nematodes in patients with diffuse unilateral subacute neuroretinitis.

Methods  Infrared, red, and blue illumination (780, 633, and 488 nm, respectively) in an SLO were used to image and evaluate functional retinal status in patients with late-stage diffuse unilateral subacute neuroretinitis. An examination to identify live nematodes was performed in the affected eyes.

Results  Using blue illumination, the ocular fundus appeared dark and provided a high-contrast background for the white image of the worm. The red laser was used to perform red-on-red perimetry. We also used perimetry stimulus to stimulate the worm's movement and pinpoint its location. We precisely defined the relation between the fixation point and the worm to plan accurate laser treatment. The infrared laser is safe and comfortable for prolonged examination. Using the SLO, several physicians simultaneously visualized the ocular fundus. Video output from the SLO provided temporal information, excellent for enhancing detection of worms, which was displayed dynamically on video.

Conclusions  Although examination with a fundus contact lens by skilled ophthalmologists is the method of choice, the SLO provides a new examination modality with distinct advantages for identifying live worms in young patients with diffuse unilateral subacute neuroretinitis.

From the Retina Ophthalmology Unit, Department of Ophthalmology, Centro Brasileiro de Cirurgia de Olhos and the Universidade Federal de Goiás, Goiânia, Brazil (Drs Moraes, Cialdini, and Avila); the Universidade Federal de São Paulo, São Paulo, Brazil (Dr Moraes); and the Schepens Eye Research Institute, Harvard Medical School, Boston, Mass (Dr Elsner). The authors have no commercial interest in the scanning laser ophthalmoscope, any hardware associated with it, or the software developed for it.

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