Varicella zoster virus acute retinal necrosis miming papillitis: a case report

Viral acute retinal necrosis is a rare acute uveitis characterized by peripheral necrotizing retinitis with severe functional damages. We reported an unusual case of varicella zoster virus acute retinal necrosis starting with optic nerve involvement.

A 55-year-old immunocompetent Caucasian woman presented with pain in the left eye and signs of papillitis with enlargement of the blind spot. Visual function rapidly decreased because of ocular inflammation within a few days. After ophthalmological and systemic tests, a diagnosis of varicella zoster virus acute retinal necrosis was made. A prompt treatment with intravenous acyclovir and early vitrectomy was performed.

Optic disc involvement preceding retinal necrosis in varicella zoster virus acute retinal necrosis is a diagnostic challenge. A prompt diagnosis and treatment are pivotal to manage these patients, avoiding severe visual damage.