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Acute retinal necrosis associated with dimethyl fumarate
Christopher Paisey1, Karen Curtin2, Simon J Epps2
1Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Background:
The full range of side effects of disease-modifying treatment for multiple sclerosis (MS) remains to be determined. To date, four serious varicella zoster virus (VZV) infections have been reported in association with dimethyl fumarate (DMF).
Report:
A 44-year-old man on DMF for relapsing remitting MS presented with monocular pain and visual impairment. Ophthalmological examination revealed panuveitis with arteritis, retinitis and vitritis. Vitreous PCR was positive for VZV confirming the clinical impression of acute retinal necrosis (ARN).
Discussion:
ARN due to VZV may mimic optic neuritis in people on disease-modifying therapy for MS.
