Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Chorioretinal Infiltration due to Moving Intraocular Caterpillar setae without Inflammation of the Anterior Segment

Käsmann-Kellner B., Bruch P. M., Ruprecht K. W. 
Universitäts-Augenklinik, Homburg/Saar

Purpose: To report a case of caterpillar setae (hair) which were moving within the choroid, leaving pathognomonical streak-like chorioretinal scars.
Method: Observational case report. In a 36-years old asymptomatic male unusual chorioretinal scars were noticed in the left eye during a routine examination. There was no associated conjunctivitis and / or anterior / intermediate uveitis. The scars were formed like separating streaks, partly acute inflammatory infiltration was seen. Anamnestically a caterpillar had been thrown into his left eye 22 years ago. Histopathology of a subconjuctival seta showed a large epitheloid cell foreign body granuloma with embedded caterpillar hairs. We also present optical and electronic microscope photographs of caterpillar hairs.
Results: Due to the acute inflammation, the area was treated using the Argon laser to induce a scar formation and thus prevent further movement of the setae.
Conclusions: Besides keratitis and conjunctivitis (ophthalmia nodosa), caterpillar hairs are known to cause iris nodules, chronic uveitis, cataract, hyalitis, chorioretinitis, and orbital cellulitis. In chorioretinal affection with partly fresh infiltrations one should perform laser treatment to produce a non-reactive scar and prevent the hair from further movement and from causing acute chorioretinitis and central lesions of the RPE.

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