Optic neuritis heralding varicella zoster virus retinitis in a patient with acquired immunodeficiency syndrome

Annals of Neurology
C MeenkenJ T van der Meer

Abstract

We report on a 29-year-old severely compromised acquired immunodeficiency syndrome patient who developed retrobulbar optic neuritis 5 weeks after an episode of cutaneous herpes zoster infection. During the optic neuritis, varicella zoster virus could be demonstrated in the cerebrospinal fluid. The neuritis responded well to treatment with foscarnet, but, 3 weeks into therapy, varicella zoster retinitis developed. Additional treatment with intravenous acyclovir stopped progression of the retinitis and resulted in healing of the retinal lesions. This case suggests that retrobulbar optic neuritis can be regarded as a prodrome of imminent acute retinal necrosis. Early recognition and prompt therapy with combined antivirals may prevent the development of this devastating ocular complication of varicella zoster infection.

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Citations

Mar 5, 2004·Survey of Ophthalmology·Tamara R Vrabec
Sep 4, 2009·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Suzann PershingYaping Joyce Liao
Mar 19, 2003·The British Journal of Ophthalmology·P FrancisS Kaushal
Mar 19, 2003·The British Journal of Ophthalmology·P J FrancisE M Graham
Dec 1, 2009·Future Neurology·Don GildenRandall J Cohrs
Jun 4, 2005·Clinical & Experimental Ophthalmology·Weng T Ng, Patrick Versace
Jul 22, 2010·Acta Ophthalmologica·Matthew T WitmerGrace A Levy-Clarke
May 28, 2016·Ocular Immunology and Inflammation·Yan Tong KohRupesh Agrawal
Sep 14, 2018·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Yong-Il ShinYeon-Hee Lee
Nov 12, 2005·Seminars in Ophthalmology·Adriana A Bonfioli, Andrew W Eller
Sep 7, 2018·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Sachin KedarJoseph R Berger
Dec 22, 2017·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Aaron R KaufmanKarl C Golnik

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