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Systemic viral infections and their retinal and choroidal manifestations
S L Yoser1, D J Forster, N A Rao
1Doheny Eye Institute, University of Southern California School of Medicine, Los Angeles.
Abstract:
Viruses are one of the most common causes of infections involving the posterior segment of the eye. Such infections can occur either on a congenital or an acquired basis, and may affect primarily the retina or the choroid. Congenital cytomegalovirus (CMV) and rubella infections may result in retinitis. CMV retinitis is also the most common cause of acquired viral retinitis, primarily because of the acquired immunodeficiency syndrome (AIDS). Other types of viral retinitis, such as those caused by herpes simplex or herpes zoster, can occur in immunocompromised or immunocompetent individuals. Retinitis or choroiditis caused by viruses such as measles, influenza, Epstein-Barr virus, and Rift Valley fever virus, typically occurs subsequent to an acute viral systemic illness. The systemic and ocular manifestations, as well as the histopathology, laboratory tests, differential diagnoses, and treatment regimens for each of the individual viruses are discussed in detail.
Insights
Viral infections commonly affect the eye's posterior segment, causing retinitis or choroiditis. This review details various viral causes, their ocular manifestations, and management strategies.
Area of Science:
- Ophthalmology
- Virology
- Infectious Diseases
Background:
- Posterior segment eye infections are frequently viral.
- These infections can be congenital or acquired, impacting the retina or choroid.
- Cytomegalovirus (CMV) and rubella are common causes of congenital infections, while CMV retinitis is prevalent in acquired immunodeficiency syndrome (AIDS) patients.
Purpose of the Study:
- To provide a comprehensive overview of viral posterior segment eye infections.
- To discuss the diverse range of viruses implicated in retinitis and choroiditis.
- To detail the clinical, diagnostic, and therapeutic aspects of these infections.
Main Methods:
- Review of literature on viral retinitis and choroiditis.
- Analysis of systemic and ocular manifestations for various viruses.
- Discussion of histopathology, laboratory diagnostics, and differential diagnoses.
Main Results:
- Congenital infections (CMV, rubella) can cause retinitis.
- CMV retinitis is a leading cause of acquired viral retinitis, especially in AIDS patients.
- Other viruses (herpes simplex, herpes zoster, measles, influenza, Epstein-Barr, Rift Valley fever) can also cause ocular disease, often post-systemic illness.
Conclusions:
- Viral infections represent a significant cause of posterior uveitis.
- Understanding the specific viral etiology is crucial for appropriate management.
- This review synthesizes key information for diagnosing and treating viral retinitis and choroiditis.