From questions on page 574

1. DESCRIBE THE FUNDUSCOPIC AND ANGIOGRAPHIC FINDINGS (FIG 1)

At initial presentation, ophthalmoscopy revealed granularity of the macula and mid-peripheral mottling of the retinal pigment epithelium in the right eye.

Fluorescein angiography (FA) showed more widespread disease with hyperfluorescent spots in the early and late phase and mild optic disc staining. Indocyanine green angiography demonstrated coalescent hypofluorescent lesions with predilection for the optic nerve, reminiscent of findings in multiple evanescent white dot syndrome (MEWDS).1

2. WHAT IS THE MOST LIKELY RESPONSIBLE ORGANISM?

Different nematodes of varying size have been implicated in the pathogenesis of diffuse unilateral subacute neuroretinitis (DUSN) including Ancylostoma canium, the small larva of Toxocara canis, and filarial worms.

When questioned, the patient reported that her patio had a recent infestation with raccoons. Although never isolated …