Jakobs E M, Adelberg D A, Lewis J M, Trpis M, Green W R
Eye Pathology Laboratory, Wilmer Institute, Baltimore, MD 21287-9248, USA.
Retina. 1997;17(4):310-4. doi: 10.1097/00006982-199707000-00006.
The prognosis for patients with ophthalmomyiasis Interna posterior is variable. In many patients the larva remains in the eye for years without inducing inflammation or loss of vision. Sometimes, however, the migrating larva involves the macula and optic nerve and results in permanent visual loss or even blindness.
Our patient presented with sudden painless loss of vision in the right eye that was caused by ophthalmomyiasis interna posterior. Hemorrhage of the optic nerve head suggested that the fly larva had entered the vitreous cavity from the optic nerve head. Subretinal tracts were sequelae of the subretinal migration of the organism. Sequential photographs documented the fly larva migration into the optic nerve head head from the vitreous cavity. The organism was removed by pars plana vitrectomy and retinectomy.
In spite of the successful removal of the first stage fly larva, the visual acuity remained poor because of optic nerve atrophy.
We suggest early removal of fly larvae to prevent damage and visual loss in cases of ocular myiasis interna posterior.
眼内后段蝇蛆病患者的预后各不相同。许多患者的幼虫在眼内留存数年，未引发炎症或视力丧失。然而，有时迁移的幼虫会累及黄斑和视神经，导致永久性视力丧失甚至失明。
我们的患者因眼内后段蝇蛆病出现右眼突发无痛性视力丧失。视神经乳头出血提示蝇幼虫从视神经乳头进入玻璃体腔。视网膜下条索是该生物体视网膜下迁移的后遗症。系列照片记录了蝇幼虫从玻璃体腔迁移至视神经乳头的过程。通过扁平部玻璃体切除术和视网膜切除术取出该生物体。
尽管成功取出了第一阶段的蝇幼虫，但由于视神经萎缩，视力仍很差。
我们建议早期取出蝇幼虫，以防止眼内后段蝇蛆病病例出现损伤和视力丧失。
