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      Ocular dirofilariasis in Dubai, UAE

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          Abstract

          A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.

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          Human dirofilariasis due to Dirofilaria (Nochtiella) repens: an update of world literature from 1995 to 2000.

          S Pampiglione, F Rivasi (2000)
          Following on from their review of 1995 (Pampiglione et al.), the authors present an update of human cases of dirofilariasis due to Dirofilaria (Nochtiella) repens (Nematoda, Filarioidea, Onchocercidae) reported in the world literature. Cases of the parasitosis published from 1995 to 2000 are reported country by country. The essential data are presented in tabular form and the clinical, parasitological, histopathological, epidemiological features are analysed. 372 new cases spread over 25 countries are thus added to the list published in 1995. The countries most affected are Italy, Sri Lanka, some republics of the ex-Soviet Union. The age of the patients varied from 4 months to 100 years, the majority being in their 40s. There was virtually no difference in incidence between sexes. The parasite appeared most frequently in the upper half of the body, particularly in the head and ocular region and also in the upper limbs. Cases of visceral involvement are also reported. Of the various forms of human dirofilariasis, that due to D. (N.) repens is confirmed to be the most important as regards not only the number of subjects affected and the wide geographical distribution but also the variety of organs involved, notably the lungs, the male genitals and the female breast, invariably leading to a wrong diagnosis of malignant tumour. In man, the zoonosis may be described as emerging: whereas until the middle of the last century only a few dozen cases were reported, in the last 50 years the number has gradually increased to reach the present 782.
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            Human dirofilariasis due to Dirofilaria (Nochtiella) repens: a review of world literature.

            S Pampiglione, F Rivasi, G Trotti (1995)
            For some Dirofilaria spp. of zoonotic importance, such as D.immitis, D.tenuis, D.ursi, reviews of human cases were often published. For D. repens there is no published information giving a picture of the importance of the problem and of the geographical distribution of the parasite in the world. From a study of the international literature and from direct experience (our workgroup observed 75 cases in Italy) we have ascertained that the condition associated with D. repens is the most frequent and the most widely distributed in the world, of the dirofilariases of medical relevance: comprehensively 397 cases were recorded in 30 countries, exclusively in the Old World, with endemic foci in Southern and Eastern Europe, Asia Minor, Central Asia and Sri Lanka. Apparently, the most affected country is Italy with a total of 168 cases. The most common localisations are the subcutaneous (normally nodular) and the submucosal (nodular or not). The most affected areas are the head, the thoracic wall and the upper limbs. However, 15 cases with internal localisations are recorded (9 of them being pulmonary) which were always diagnosed erroneously as malignant neoplasiae. Clinical diagnosis for the other localisations was also generally wrong with the exception of the subconjunctival cases, where because of the transparency of the bulbar conjunctiva, it is possible to see the parasite directly. The correct diagnosis is usually histological, based on the identification of the nematode using the morphological characters of the species to differentiate it from the other dirofilariae or other erratic nematodes. It is possible that the zoonosis in man is more frequent than shown by the literature: many cases are not diagnosed, viz. not published, others recover spontaneously without medical intervention.
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              Intraocular filariasis: a brief review.

              R Beaver (1988)
              Fifty-six cases of human intraocular filariasis have been reported. In 6, the objects interpreted as filariae may have been artifacts. In 8, a motile worm that apparently was not a filaria was observed. In the remainder, a motile filaria or filaria-like worm was observed, but in only 6 cases were the filariae removed from the eye, described, and identified. Three of these were identified as Dipetalonema spp., and one each as Wuchereria, Dirofilaria, and Loaina. In 10 cases, filariae were removed and identified as Loa loa (6) or Wuchereria bancrofti (4) but without a supporting description. A filaria was removed but not satisfactorily described or identified in 8 cases, spontaneously disappeared in 4, died following treatment in 4, and met unreported fates in seven. For 3 the original reports were inaccessible. Records of intraocular filariae that are not supported by morphological description are questionable.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Ophthalmol
                Journal ID (publisher-id): Indian Journal of Ophthalmology
                Title: Indian Journal of Ophthalmology
                Publisher: Medknow Publications (India )
                ISSN (Print): 0301-4738
                ISSN (Electronic): 1998-3689
                Publication date (Print): Jul-Aug 2008
                Volume: 56
                Issue: 4
                Pages: 325-326
                Affiliations
                Department of Ophthalmology, Welcare Ambulatory Care Centre (MM), Welcare Hospital (KRS, PGB), Welcare Eye Centre (BSC), Dubai, UAE.
                Author notes
                Correspondence to Dr. Prashant G Bhatia, Department of Ophthalmology, Welcare Hospital, P.O. Box 31500, Dubai, UAE. Email: drprashantbhatia@ 123456gmail.com
                Article
                Publisher ID: IndianJOphthalmol_2008_56_4_325_41417
                PMC ID: 2636165
                PubMed ID: 18579995
                SO-VID: c47e1143-3406-45c0-af3a-faaaec9fb5d1
                Copyright © Copyright: © Indian Journal of Ophthalmology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 15 June 2007
                Date accepted : 03 October 2007
                Categories
                Subject: Brief Communication

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: dirofilaria repens,zoonotic infection,ocular dirofilariasis,subconjunctival dirofilariasis
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: dirofilaria repens, zoonotic infection, ocular dirofilariasis, subconjunctival dirofilariasis

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