ORBITAL CYSTICERCOSIS

Background: Human cysticercosis is secondary to an infestation by cyst icercus cellulosae, the larval form of Taenia solium. Cysticercosis is endemic to regions with poor sanitation. The purpose of this report i s to present a large series of patients with orbital cysticercosis and to discuss the current treatment. Methods: A retrospective chart anal ysis of all patients with orbital cysticercosis from an urban practice in southern India was performed. The clinical features, the results o f investigations, the therapies instituted, and the outcomes realized were recorded. Results: Twenty patients diagnosed with orbital cystice rcosis were identified (11 female and 9 male). Their ages ranged from 5 to 25 years with a mean age of 12.5 years. Nine patients manifested subconjunctival cysts. Eight were excised and 5 of these were densely adherent to the adjacent extraocular muscle (EOM). The remaining 11 pa tients had a cyst in a single EOM. The EOM cysts had proptosis, restri cted motility, recurrent inflammation, and blepharoptosis. Two of the EOM cysts were excised surgically and four extruded spontaneously. Six patients with EOM cysts were treated medically: they all received ora l corticosteroids and, additionally, five were given oral albendazole and one was given oral praziquantel. Conclusions: Excisional biopsy is recommended for subconjunctival cysticercosis. Idiopathic cystic myos itis can present like EOM cysticercosis, but is differentiated by reso lution with corticosteroid treatment. Medical therapy in orbital cysti cercosis with oral albendazole and corticosteroids can arrest recurren t inflammation and improve ocular motility.