Ophthalmomyiasis interna posterior and pigmentary retinopathy of Guam.

BACKGROUND

Ophthalmomyiasis is ocular invasion by a fly larva. In the United States, only two cases of bilateral subretinal ophthalmomyiasis have been reported in the literature. Subretinal invasion by the fly larva results in characteristic ophthalmoscopic and angiographic findings. Recently, similar subretinal changes have been associated with amyotrophic lateral sclerosis/Parkinsonism dementia complex (ALS-PDC) in the Chamorro population of Guam. This pigmentary retinopathy of Guam (PROG) is generally bilateral in presentation, whereas ophthalmomyiasis is generally unilateral. While PROG has been associated with neurologic findings, ophthalmomyiasis interna posterior (OIP) has not.

CASE REPORT

A case of a 65-year-old Asian man with bilateral subretinal changes is described. Similarities and differences between ophthalmomyiasis and the pigmentary retinopathy of Guam are discussed.

CONCLUSIONS

Because PROG has been associated with ALS-PDC, a neurologic evaluation should be included in the workup of patients suspected of having OIP or PROG.