Herpes zoster chorioretinopathy

Chorioretinitis and subsequent choroidal and retinal pigment epithelial atrophy following herpes zoster ophthalmicus (HZO) have rarely been reported. We report two patients, who several months following attacks of acute HZO, developed posterior fundus features of yellow, non-pigmented, punched-out areas of retinal pigment epithelial and choroidal pigment atrophy, which we have termed herpes zoster chorioretinopathy. An occlusive vasculitic process is proposed as the pathogenesis for this chorioretinopathy, and may be similar to that seen in the delayed cerebral vasculitis following HZO. A previous history of HZO should be sought in patients with a unilateral, multifocal, non-pigmented chorioretinopathy, as this may represent a characteristic delayed feature.