Varicella-Zoster Virus and the Eye: Clinical Spectrum, Management, and Vaccination

Area of Science:

• Ophthalmology
• Virology
• Immunology

Background:

• Varicella-Zoster Virus (VZV) is a significant cause of ocular disease.
• Reactivation can affect various eye structures, including the adnexa, cornea, sclera, uvea, optic nerve, and orbit.
• Ocular VZV can occur with or without skin manifestations, necessitating advanced diagnostics.

Purpose of the Study:

• To review current knowledge on Varicella-Zoster Virus ocular disease.
• To focus on host-pathogen interactions in VZV-induced ocular injury and defense.
• To highlight diagnostic and management strategies for VZV eye conditions.

Main Methods:

• Literature review synthesizing current research on VZV ocular disease.
• Analysis of host-pathogen interactions driving ocular inflammation and damage.
• Discussion of diagnostic tools like PCR and treatment modalities.

Main Results:

• VZV reactivation presents with diverse ocular manifestations, from keratitis and uveitis to retinal necrosis and cranial nerve palsies.
• Ocular VZV can occur without cutaneous signs (zoster sine herpete).
• Early antiviral therapy (acyclovir, valacyclovir), corticosteroids, and surgery are crucial for management.

Conclusions:

• Varicella-Zoster Virus poses a substantial threat to vision, requiring prompt diagnosis and treatment.
• Vaccination strategies are reducing VZV incidence, but vigilance for rare post-vaccine complications is necessary.
• Understanding host-pathogen interactions is vital for developing future therapeutic approaches.