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Varicella zoster virus-associated neuroretinitis
Wei-Shan Tsao1, Ming-Shan He1, Rong-Kung Tsai2,3
1Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Taiwan Journal of Ophthalmology
|October 12, 2017
Summary
Varicella zoster virus (VZV) can cause rare neuroretinitis, leading to vision loss. Early treatment with oral acyclovir improved visual acuity and restored retinal layers in a patient with VZV neuroretinitis.
Area of Science:
- Ophthalmology
- Virology
- Neuroscience
Background:
- Varicella zoster virus (VZV) neuroretinitis is an uncommon condition.
- Prompt diagnosis and treatment are crucial for visual recovery.
Observation:
- A patient presented with blurred vision and eye pain, exhibiting disc edema, hyperemia, and macular edema.
- Initial treatment with corticosteroids yielded incomplete visual recovery, with optical coherence tomography (OCT) revealing photoreceptor disruption.
Findings:
- Laboratory results confirmed a high VZV immunoglobulin G titer, leading to a diagnosis of VZV-associated neuroretinitis.
- Administration of oral acyclovir resulted in significant visual acuity improvement (to 0.9) and OCT-confirmed photoreceptor layer restoration within two weeks.
Implications:
- This case highlights the importance of considering VZV in neuroretinitis cases, even with initial atypical presentations.
- Spectrum-domain OCT is a valuable tool for monitoring disease progression and treatment response in neuroretinitis.
- Antiviral therapy with acyclovir can effectively manage VZV neuroretinitis, leading to substantial visual recovery.
