Ocular dirofilariasis: a clinicopathologic case series and literature review

Abstract Purpose Ocular dirofilariasis is an uncommon zoonotic infection that is usually associated with a carnivore host. In this case series and literature review we investigate the clinical presentation, management, and histopathology of ocular dirofilariasis. Methods The database at the Florida Lions Ocular Pathology Laboratory was searched for surgical specimens at the Bascom Palmer Eye Institute under approval of the institutional review board. Patients with a histopathologic diagnosis of dirofilariasis between the years of 1962 and 2022 from the Florida Lions Ocular Pathology laboratory database were included (n=3). A systematic Pubmed search was conducted by two independent authors to identify published cases of ophthalmic dirofilariasis worldwide. Keywords were used to identify articles and exclusion criteria were applied. Results Three patients, two males and one female, were identified from the Florida Lions Ocular Pathology database with a diagnosis of ocular dirofilariasis. The mean age was 46.7 years (with a range 33-57 years). There were two eyelid lesions (Cases 1 and 3) and one involving the subconjunctival space (Case 2). All three organisms were excised and presumptively identified as Dirofilaria tenuis. All three patients were managed with curative surgical removal and recovered completely. Our review of the literature identified 540 published reports with 142 published reports with 186 cases met the exclusion criteria. Conclusion We present a case series and literature review of ocular dirofilariasis. Knowledge of the incidence, risk factors, prevention and diagnosis of this unique parasitic infection will help in proper management and prevent further ocular complications.