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Zoster sine herpete with bilateral ocular involvement
M Nakamura1, M Tanabe, Y Yamada
1Department of Ophthalmology, Kobe University School of Medicine, Kobe, Japan. mxn15@psu.edu
Purpose:
To report a case of zoster sine herpete with bilateral ocular involvement.
Method:
Case report.
Results:
A 65-year-old man showed bilateral iridocyclitis with sectoral iris atrophy and elevated intraocular pressure unresponsive to steroid treatment. No cutaneous eruption was manifest on the forehead. A target region of varicella-zoster virus DNA sequence was amplified from the aqueous sample from the left eye by polymerase chain reaction. Bilateral iridocyclitis resolved promptly after initiation of systemic and topical acyclovir treatment. Secondary glaucoma was well controlled by bilateral trabeculectomy.
Conclusions:
Zoster sine herpete should be considered and polymerase chain reaction performed on an aqueous sample to detect varicella-zoster virus DNA for rapid diagnosis whenever anterior uveitis accompanies the characteristic iris atrophy, even in the case of bilateral involvement.