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[Post-varicella acute retinal necrosis]

A Ehongo-Bidime1, A Pereleux, A Zanen

  • 1Service d'ophtalmologie, Hôpital Erasme, Université Libre de Bruxelles.

Bulletin De La Societe Belge D'Ophtalmologie
|January 1, 1995
PubMed
Summary

A 43-year-old man experienced sudden vision loss due to varicella-zoster virus (VZV) infection, leading to acute retinal necrosis. Prompt treatment with antivirals and steroids resulted in a favorable visual recovery.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Virology

Background:

  • Chickenpox, caused by the varicella-zoster virus (VZV), can lead to serious ocular complications.
  • Acute retinal necrosis (ARN) is a rare but severe intraocular inflammation.
  • Early diagnosis and treatment are crucial for managing VZV-related ocular conditions.

Observation:

  • A 43-year-old healthy male presented with sudden blurred vision in his right eye.
  • Examination revealed intraocular inflammation and retinal necrosis in the temporal periphery.
  • Positive IgM and IgG antibodies confirmed recent VZV infection, with intraocular antibody production detected.

Findings:

  • The patient was diagnosed with acute retinal necrosis secondary to VZV infection.
  • Negative serology for other common pathogens like HSV, HIV, and CMV ruled out alternative causes.
  • Intraocular anti-VZV antibody production (Goldmann-Witmer ratio = 1338) indicated a localized immune response.

Implications:

  • This case highlights the potential for VZV to cause severe ocular complications like ARN.
  • Successful treatment with acyclovir, corticosteroids, and local procedures led to visual recovery.
  • The findings underscore the importance of considering VZV in cases of necrotizing retinitis, even in immunocompetent individuals.

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