Vision Loss in Neurocysticercosis: Clinical Features, Diagnostic Approaches, and Treatment Outcomes: a systematic review of case report and case series

Background

Neurocysticercosis is a parasitic infection caused by Taenia solium larvae, leading to various neurological symptoms, including vision loss. This systematic review critically analyzes cases of vision loss associated with neurocysticercosis to evaluate diverse etiologies and assess the visual prognosis.

Methods

This review follows the PRISMA guidelines and is registered with the International Prospective Register of Systematic Reviews (registration number: CRD42024556278). Reports involving human subjects with vision loss due to neurocysticercosis were included. Databases searched included PubMed, Scopus, Embase, and Google Scholar.

Results

A total of 148 records, encompassing 168 patients, were included. The mean age was 27.3 years, with 41 percent females and 58.3 percent males. The majority of cases were from Asia. The duration of illness varied, with most cases spanning one month to six months. Common symptoms included headache or orbital pain. Vision loss was predominantly unilateral. Imaging abnormalities included multiple cystic brain lesions, enhancing brain lesions, and calcified lesions. The most affected structures were the intravitreal and retinal regions, followed by the anterior chamber, orbital apex, and optic nerve. Anticysticercal drugs were the main treatment, with 60.12 percent showing improvement.

Conclusions

Vision loss in neurocysticercosis is primarily due to the involvement of the intravitreal and retinal regions, with frequent occurrence of multiple cystic brain lesions.

Anticysticercal treatment leads to significant improvement in many cases, although surgical intervention is often required for intravitreal or retinal cysts. The prognosis varies, with the majority of patients had improved vision, though some experience severe outcomes such as eye enucleation.