1
|
Phan AQ, Hands JM, Khosa S, Mishra SK. Acute Retinal Necrosis due to Varicella Zoster Virus Presenting Initially as Central Retinal Artery Occlusion and Posterior Ischemic Optic Neuropathy. J Neuroophthalmol 2024; 44:e320-e322. [PMID: 37656515 DOI: 10.1097/wno.0000000000001964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Affiliation(s)
- Allan Q Phan
- Department of Neurology (AQP), David Geffen School of Medicine at UCLA, Los Angeles, California; The George Washington University School of Medicine and Health Sciences (JMH), Washington DC; Department of Neurology (SK, SKM), Olive View-UCLA Medical Center, Sylmar, California
| | | | | | | |
Collapse
|
2
|
Acute retinal necrosis: clinical features, management and outcomes. Int Ophthalmol 2022; 43:1987-1994. [DOI: 10.1007/s10792-022-02598-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 11/12/2022] [Indexed: 11/28/2022]
|
3
|
An atypical case of viral panuveitis and retinal vasculitis with retrograde extension associated with human herpesvirus-6. Am J Ophthalmol Case Rep 2022; 28:101712. [PMID: 36275189 PMCID: PMC9579305 DOI: 10.1016/j.ajoc.2022.101712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/01/2022] [Accepted: 09/17/2022] [Indexed: 11/09/2022] Open
|
4
|
Sarpangala S, George NM, Kamath YS, Kulkarni C. Central retinal vein occlusion secondary to varicella zoster retinal vasculitis in an immunocompetent individual during the COVID-19 pandemic - A case report. Indian J Ophthalmol 2021; 69:2532-2535. [PMID: 34427261 PMCID: PMC8544091 DOI: 10.4103/ijo.ijo_1644_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
We report the occurrence of unilateral central retinal vein occlusion (CRVO) in a young yoga enthusiast who presented amidst the COVID-19 pandemic. Subtle signs of uveitis when systemically investigated revealed a multitude of causes, but ocular fluid polymerase chain reaction was positive for varicella zoster virus (VZV). The prompt initiation of antivirals resulted in a good visual outcome. Our case describes the rare presentation of VZV retinal vasculitis as CRVO in a young healthy individual and highlights the importance of early antiviral therapy for favorable outcomes.
Collapse
Affiliation(s)
- Shailaja Sarpangala
- Department of Ophthalmology, Kasturba Medical College- Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Neenu M George
- Department of Ophthalmology, Kasturba Medical College- Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Yogish S Kamath
- Department of Ophthalmology, Kasturba Medical College- Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Chidanand Kulkarni
- Department of Ophthalmology, Kasturba Medical College- Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
5
|
Kaur P, Kaza H, Pathengay A. Acute retinal necrosis with central retinal artery obstruction. BMJ Case Rep 2020; 13:13/12/e238589. [PMID: 33372020 PMCID: PMC7772293 DOI: 10.1136/bcr-2020-238589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Prabhjot Kaur
- Retina and Vitreous Service, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam, India
| | - Hrishikesh Kaza
- Uveitis Service, L V Prasad Eye Institute, KAR Campus, Banjara Hills, Hyderabad, India
| | - Avinash Pathengay
- Retina and Vitreous Service, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam, India
| |
Collapse
|
6
|
Özdemir HB, Özdal PÇ. Human Adenovirus: An Unusual Causative Agent for Acute Retinal Necrosis Presented with Central Retinal Vascular Occlusion. Ocul Immunol Inflamm 2020; 28:749-753. [PMID: 31411554 DOI: 10.1080/09273948.2019.1624780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE We describe a case of acute retinal necrosis (ARN) with central retinal vascular occlusion caused by human adenovirus (HAdV). CASE REPORT A 41-year-old man presented with a sudden decrease of visual acuity in his right eye since seven days. Visual acuity was hand movements and ophthalmic examination of the right eye revealed diffuse hemorrhagic retinal vasculitis with panuveitis. He was clinically diagnosed as ARN with central retinal vascular occlusion. An anterior chamber paracentesis and intravitreal ganciclovir injection were performed and intravenous ganciclovir has been initiated immediately. Polymerase chain reaction (PCR) analysis of aqueous humor identified HAdV DNA as a causative agent. Oral prednisolone was added to treatment 5 days after antiviral therapy. After 10 days of intravenous ganciclovir therapy, oral valganciclovir was given for 6 months. No recurrence or retinal detachment occurred during follow-up. CONCLUSION HAdV known to cause acute epibulbar infections of the eye may also cause intraocular inflammation such as ARN.
Collapse
Affiliation(s)
- Hüseyin Baran Özdemir
- Ulucanlar Eye Training and Research Hospital, University of Health Sciences , Ankara, Turkey
| | - Pınar Çakar Özdal
- Ulucanlar Eye Training and Research Hospital, University of Health Sciences , Ankara, Turkey
| |
Collapse
|
7
|
Agarwal M, Gupta C, Jain A, Kumar B. Branch Retinal Artery Occlusion as a presenting sign of Acute Retinal Necrosis: a rare association. J Ophthalmic Inflamm Infect 2020; 10:8. [PMID: 32052206 PMCID: PMC7016156 DOI: 10.1186/s12348-020-0199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/26/2019] [Indexed: 11/16/2022] Open
Abstract
Background Acute retinal necrosis (ARN) is a potentially blinding necrotizing viral retinitis. It starts with one or more foci and spreads circumferentially and involves the posterior pole in the later stages. Vascular occlusions such as branch retinal artery occlusion, central retinal artery occlusion, and central retinal vein occlusion may occur secondary to underlying infectious etiology such as ARN. Findings An elderly male patient with a history of coronary artery disease was diagnosed with branch retinal artery occlusion (BRAO) in the right eye and referred to the treating cardiologist. Few days later, he complained of diminution of vision in the left eye which made him seek another consultation when he was diagnosed to have ARN in the left eye, encroaching the posterior pole. He was investigated and treated for the same leading to minimal improvement of vision in the left eye possibly due to a delay in the starting of the anti-viral therapy. Conclusion We report this case to highlight that occlusive vasculopathy can be a presenting sign of an underlying infectious etiology in any age group. BRAO was a rare presenting sign of ARN in our patient. A thorough peripheral examination is recommended in order to avoid missing infectious pathologies such as ARN which starts from the retinal periphery, progresses fast, and if not managed on time may lead to permanent loss of vision.
Collapse
Affiliation(s)
- Manisha Agarwal
- Vitreo-retina Department, Dr Shroff's Charity Eye Hospital, 5072, Kedarnath Road, Daryaganj, New Delhi, 110002, India.
| | - Chanda Gupta
- Vitreo-retina Department, Dr Shroff's Charity Eye Hospital, 5072, Kedarnath Road, Daryaganj, New Delhi, 110002, India
| | - Abhishek Jain
- Vitreo-retina Department, Dr Shroff's Charity Eye Hospital, 5072, Kedarnath Road, Daryaganj, New Delhi, 110002, India
| | - Brajesh Kumar
- Vitreo-retina Department, Dr Shroff's Charity Eye Hospital, 5072, Kedarnath Road, Daryaganj, New Delhi, 110002, India
| |
Collapse
|
8
|
Shah SP, Hadid OH, Graham EM, Stanford MR. Acute Retinal Necrosis Presenting as Central Retinal Artery Occlusion with Cilioretinal Sparing. Eur J Ophthalmol 2018; 15:287-8. [PMID: 15812776 DOI: 10.1177/112067210501500220] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To report a case of acute retinal necrosis presenting as central retinal artery occlusion with cilioretinal sparing. Methods Single inter ventional case report. The findings of the ophthalmic examination, MRI, blood parameters, biopsy results and clinical course are reported. Results A forty two year old gentleman reporting sudden loss of sight, ophthalmic examination revealing uveitis, central retinal artery occlusion with cilioretinal sparing and peripheral necrotizing retinitis. Conclusions Central retinal artery occlusion can be an early feature of acute retinal necrosis (ARN).
Collapse
Affiliation(s)
- S P Shah
- Medical Eye Unit, St Thomas' Hospital, London--UK.
| | | | | | | |
Collapse
|
9
|
Bansal R, Singh R, Takkar A, Lal V. Combined central retinal artery and vein occlusion with optic perineuritis following herpes zoster dermatitis in an immunocompetent child. Indian J Ophthalmol 2017; 65:1233-1235. [PMID: 29133663 PMCID: PMC5700605 DOI: 10.4103/ijo.ijo_480_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A 15-year-old healthy boy developed acute, rapidly progressing visual loss in left eye following herpes zoster dermatitis, with a combined central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO), along with optic perineuritis. Laboratory tests were negative. Despite an empirical, intensive antiviral treatment with systemic corticosteroids, and vision could not be restored in the affected eye. Herpes zoster dermatitis, in an immunocompetent individual, may be associated with a combined CRAO and CRVO along with optic perineuritis, leading to profound visual loss.
Collapse
Affiliation(s)
- Reema Bansal
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ramandeep Singh
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aastha Takkar
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Lal
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
10
|
ADULT WITH CHICKENPOX COMPLICATED BY SYSTEMIC VASCULITIS AND BILATERAL RETINAL VASCULITIS WITH RETINAL VASCULAR OCCLUSIONS. Retin Cases Brief Rep 2016; 11:364-368. [PMID: 27533640 DOI: 10.1097/icb.0000000000000372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To describe an adult with chickenpox resulting in systemic vasculitis and bilateral retinal vascular occlusions. METHODS Single case report. RESULTS A 58-year-old man with chickenpox complicated by disseminated varicella-zoster systemic and retinal vasculitis resulting in a combined arterial and venous occlusion in one eye with multiple branch retinal vein occlusions in the other eye. There was no evidence of retinitis. The patient systemically improved after treatment with acyclovir and steroids; however, his vision remained poor. CONCLUSION Chickenpox can be associated with systemic vasculopathy and may rarely result in multiple systemic and ocular infarcts, including severe retinal vascular occlusions.
Collapse
|
11
|
Koh YT, Ang BCH, Ho SL, Beng Teoh SC, Agrawal R. Herpes Simplex Acute Retinal Necrosis Presenting as Unilateral Disc Swelling in Young Immunocompetent Patients. Ocul Immunol Inflamm 2016; 25:797-801. [DOI: 10.1080/09273948.2016.1175643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Yan Tong Koh
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Bryan Chin-Hou Ang
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Su Ling Ho
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Stephen Charn Beng Teoh
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Eagle Eye Center, Gleneagles Hospital, Singapore
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Institute of Ophthalmology, University College London, London, UK
| |
Collapse
|
12
|
Weissman HM, Biousse V, Schechter MC, Del Rio C, Yeh S. Bilateral central retinal artery occlusion associated with herpes simplex virus-associated acute retinal necrosis and meningitis: case report and literature review. Ophthalmic Surg Lasers Imaging Retina 2015; 46:279-83. [PMID: 25707059 DOI: 10.3928/23258160-20150213-24] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 10/01/2014] [Indexed: 11/20/2022]
Abstract
A 60-year-old woman with a history of recurrent headaches and blurred vision presented with bilateral optic disc edema. Optic neuritis was suspected, and intravenous methylprednisonlone was administered. Her vision declined to hand motions in both eyes, and subsequent evaluation revealed bilateral acute retinal necrosis with bilateral central retinal artery occlusions (CRAO). Aqueous humor polymerase chain reaction analysis was positive for herpes simplex virus (HSV), establishing a diagnosis of HSV-associated bilateral acute retinal necrosis (ARN) and meningitis. CRAO has rarely been reported in association with ARN, and a fulminant course with bilateral CRAO in association with ARN has not been previously reported. This case emphasizes the importance of careful peripheral examination in patients with presumptive optic neuritis, judicious use of systemic corticosteroid in this context, and the retinal vaso-obliterative findings that may be observed in the pathogenesis of ARN.
Collapse
MESH Headings
- Antibodies, Viral/blood
- Antiviral Agents/therapeutic use
- Aqueous Humor/virology
- DNA, Viral/genetics
- Drug Therapy, Combination
- Eye Infections, Viral/diagnosis
- Eye Infections, Viral/drug therapy
- Eye Infections, Viral/virology
- Female
- Fluorescein Angiography
- Foscarnet/therapeutic use
- Ganciclovir/therapeutic use
- Herpes Simplex/diagnosis
- Herpes Simplex/drug therapy
- Herpes Simplex/virology
- Herpesvirus 2, Human/genetics
- Herpesvirus 2, Human/immunology
- Herpesvirus 2, Human/isolation & purification
- Humans
- Magnetic Resonance Imaging
- Meningitis, Viral/diagnosis
- Meningitis, Viral/drug therapy
- Meningitis, Viral/virology
- Middle Aged
- Polymerase Chain Reaction
- Retinal Artery Occlusion/diagnosis
- Retinal Artery Occlusion/drug therapy
- Retinal Artery Occlusion/virology
- Retinal Necrosis Syndrome, Acute/diagnosis
- Retinal Necrosis Syndrome, Acute/drug therapy
- Retinal Necrosis Syndrome, Acute/virology
Collapse
|
13
|
Kahloun R, Abroug N, Ksiaa I, Mahmoud A, Zeghidi H, Zaouali S, Khairallah M. Infectious optic neuropathies: a clinical update. Eye Brain 2015; 7:59-81. [PMID: 28539795 PMCID: PMC5398737 DOI: 10.2147/eb.s69173] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Different forms of optic neuropathy causing visual impairment of varying severity have been reported in association with a wide variety of infectious agents. Proper clinical diagnosis of any of these infectious conditions is based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular findings. Diagnosis is confirmed by serologic testing and polymerase chain reaction in selected cases. Treatment of infectious optic neuropathies involves the use of specific anti-infectious drugs and corticosteroids to suppress the associated inflammatory reaction. The visual prognosis is generally good, but persistent severe vision loss with optic atrophy can occur. This review presents optic neuropathies caused by specific viral, bacterial, parasitic, and fungal diseases.
Collapse
Affiliation(s)
- Rim Kahloun
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Nesrine Abroug
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Imen Ksiaa
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Anis Mahmoud
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Hatem Zeghidi
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sonia Zaouali
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| |
Collapse
|
14
|
Zhang L, Liu JJ, Li MT. Herpes simplex virus type 1 encephalitis and unusual retinitis in a patient with systemic lupus erythematosus. Lupus 2013; 22:1403-8. [PMID: 23970491 DOI: 10.1177/0961203313502112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this report we discuss a case of a patient with systemic lupus erythematosus who developed herpes simplex virus type 1(HSV-1) infection presenting with encephalitis as well as necrotic and non-necrotic retinitis. The patient presented with typical clinical symptoms and radiologic abnormalities consistent with HSV-1 encephalitis and HSV-1 retinitis in patients with HIV infection, but lacked cerebrospinal fluid pleocytosis and had bilateral retinitis with poor visual acuity. To the best of our knowledge, this is the first such case reported in the literature.
Collapse
Affiliation(s)
- L Zhang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, China
| | - JJ Liu
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, China
| | - MT Li
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, China
| |
Collapse
|
15
|
Attia S, Khochtali S, Mbarek S, Amor SB, Zaouali S, Messaoud R, Khairallah M. Acute Retinal Necrosis Associated With Central Retinal Artery Occlusion Followed After its Resolution by Keratouveitis. Ocul Immunol Inflamm 2013; 21:405-7. [DOI: 10.3109/09273948.2013.801992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
16
|
Witmer MT, Pavan PR, Fouraker BD, Levy-Clarke GA. Acute retinal necrosis associated optic neuropathy. Acta Ophthalmol 2011; 89:599-607. [PMID: 20645925 DOI: 10.1111/j.1755-3768.2010.01911.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Acute retinal necrosis (ARN) syndrome is characterized by severe intraocular inflammation, occlusive vasculopathy and peripheral retinal necrosis. Vision threatening complications of this syndrome include retinal detachment, macular oedema and ischaemia and optic neuropathy. Optic nerve involvement may be the presenting sign of ARN and this condition should be included in the differential diagnosis of acute papillitis. Several mechanisms may lead to ARN associated optic neuropathy including vasculitis, optic nerve ischaemia and direct optic nerve invasion by the herpes virus. We review optic nerve involvement during ARN and present its incidence, pathogenesis, differential diagnosis and treatment.
Collapse
Affiliation(s)
- Matthew T Witmer
- Department of Ophthalmology, College of Medicine, University of South Florida, Tampa, Florida, USA.
| | | | | | | |
Collapse
|
17
|
Kim SW, Oh J, Huh K. Macular infarction after intravitreal ganciclovir injection in a patient with acute retinal necrosis. Can J Ophthalmol 2008; 43:124-5. [PMID: 18219358 DOI: 10.3129/i07-201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
18
|
Sáenz-Francés F, Calvo-González C, Jiménez-Santos M, Méndez-Hernández C, Fernandez-Vidal AM, Martínez-de-la-Casa JM, García-Sánchez J, García-Feijoó J. Herpetic optic neuritis associated with herpetic keratitis. Eur J Ophthalmol 2007; 17:683-4. [PMID: 17671953 DOI: 10.1177/112067210701700435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report a case of herpetic optic neuritis associated with herpetic keratitis. METHODS A 65 year old woman presented with oedema in the nasal sector of his right papilla. Blood biochemistry, a haemogram, erythrocyte sedimentation rate and C-reactive protein were all normal. The patient was diagnosed as having a non-arteritic anterior ischaemic optic neuropathy. One week later slit lamp examination showed diffuse stromal corneal oedema and a dendritic lesion in the nasal zone of the corneal epithelium. RESULTS Serology for varicela-zoster virus was positive. Treatment was started with valacyclovir given orally and topical acyclovir ointment. A week later, the optic disc swelling and corneal lesions had resolved. CONCLUSIONS The precise mechanism through which the papilla and cornea were successively affected in our patient is unclear but the sensitive innervation of both these structures is provided by the nasal branch of the nasociliary nerve and the spread of herpes via this nerve could affect both sites.
Collapse
Affiliation(s)
- F Sáenz-Francés
- Department of Ophthalmology, Hospital Clinico Universitario San Carlos-Universidad Complutense, 28003 Madrid, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Kojima M, Kimura H, Yodoi Y, Matsunaga N, Ogura Y. PRECEDING OF OPTIC NERVE INVOLVEMENT IN ACUTE RETINAL NECROSIS. Retina 2004; 24:297-9. [PMID: 15097893 DOI: 10.1097/00006982-200404000-00017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Mayu Kojima
- Department of Ophthalmology, Kyoritu Juzen Hospital, Shizuoka, Japan.
| | | | | | | | | |
Collapse
|
20
|
Francis PJ, Jackson H, Stanford MR, Graham EM. Inflammatory optic neuropathy as the presenting feature of herpes simplex acute retinal necrosis. Br J Ophthalmol 2003; 87:512-4. [PMID: 12642331 PMCID: PMC1771593 DOI: 10.1136/bjo.87.4.512-a] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|