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Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 72

High definition spectral domain: Optical coherence tomography image of caterpillar hair on the retina


Department of Vitreo-Retinal Surgery and Uveitis, Comtrust Charitable Eye Hospital, Calicut, Kerala, India

Date of Submission25-Mar-2020
Date of Acceptance11-Aug-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Divya Mohanchandran Nair
Consultant,Department of Vitreo-Retinal Surgery and Uveitis, Comtrust Charitable Eye Hospital, Calicut, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_681_20

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  Abstract 


Keywords: SD-OCT image, caterpillar hair, retina


How to cite this article:
Nair DM, Prakash V S, Din G. High definition spectral domain: Optical coherence tomography image of caterpillar hair on the retina. Indian J Ophthalmol Case Rep 2021;1:72

How to cite this URL:
Nair DM, Prakash V S, Din G. High definition spectral domain: Optical coherence tomography image of caterpillar hair on the retina. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Mar 6];1:72. Available from: https://www.ijoreports.in/text.asp?2021/1/1/72/305536



A 20-year-old female was referred to the retina clinic with complaints of redness and mild pain for 1 month. She had a history of recurrent redness and multiple caterpillar hair removals from the cornea and conjunctiva in the past 2 years. She was asymptomatic for the last 1 year. On examination, her best-corrected visual acuity was 6/6 in the right eye and 6/12 in the left eye. The anterior segment showed circumcorneal congestion, anterior chamber cells 4+, and 1 mm hypopyon. Fundus showed cells in the anterior vitreous face, hyperemic disc, and encapsulated setae in the inferotemporal quadrant embedded on the retinal surface. Fundus photo and spectral-domain optical coherence tomography (SD-OCT) (CIRRUS HD-OCT Model 4000 – Zeiss) through the caterpillar hair were obtained [Figure 1].
Figure 1: (a) Fundus photo of LE showing encapsulated caterpillar hair (white arrow) on the retina in the inferonasal quadrant. (b) High-definition SD-OCT through the lesion shows the hyper-reflective structure (yellow arrow) corresponding to the caterpillar hair, a hypo-reflective echo around and hyper-reflective echo (red arrow) corresponding to capsule

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She was started on topical prednisolone acetate 1% eye drops hourly and homatropine eye drops three times/day. On the third day, her symptoms had reduced. The anterior segment showed cells1+, no hypopyon, and a suspicious free-floating caterpillar hair in the inferior vitreous. She was managed conservatively and additional vitrectomy and surgical removal of caterpillar hair were planned. However, she was lost to follow-up.


  Discussion Top


The migration of caterpillar hair from the anterior segment to the posterior segment is well-documented.[1] Caterpillar hair has been reported to cause pars planitis, vitritis, and endophthalmitis.[2],[3] It responds well to topical and oral steroids. Recurrent inflammation is common. Pars plana vitrectomy with removal of caterpillar hair is the definite management.[3],[4]

In the present case, SD-OCT was done to study the OCT characteristics of caterpillar hair. Though only the edge of the caterpillar hair could be seen on the fundus photo, SD-OCT demarcates the hyper-reflective linear echo by the caterpillar hair and the encapsulated hyper-reflective capsular covering.

This report shows that SD-OCT is a valuable tool in imaging caterpillar setae in the posterior segment of the eye.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sengupta S, Reddy P, Gyatsho J, Ravindran R, Thiruvengadakrishnan K, Vaidee V. Risk factors for intraocular penetration of caterpillar hair in Ophthalmia Nodosa: A retrospective analysis. Indian J Ophthalmol 2010;58:540-3.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Bhende M, Biswas J, Sharma T, Chopra S, Gopal L, Shroff C. Ultrasound biomicroscopy in the diagnosis and management of pars planitis caused by caterpillar hairs. Am J Ophthalmol 2000;130:125-6.  Back to cited text no. 2
    
3.
Agarwal M, Acharya M, Majumdar S, Paul L. Managing multiple caterpillar hair in the eye. Indian J Ophthalmol 2017;65:248-50.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Sridhar M, Ramakrishnan M. Ocular lesions caused by caterpillar hairs. Eye (Lond) 2004;18:540-3.  Back to cited text no. 4
    


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