Optic neuritis heralding varicella zoster virus retinitis in a patient with acquired immunodeficiency syndrome.
We report on a 29-year-old severely compromised acquired immunodeficiency syndrome patient who developed retrobulbar optic neuritis 5 weeks after an episode of cutaneous herpes zoster infection. During the optic neuritis, varicella zoster virus could be demonstrated in the cerebrospinal fluid. The neuritis responded well to treatment with foscarnet, but, 3 weeks into therapy, varicella zoster retinitis developed. Additional treatment with intravenous acyclovir stopped progression of the retinitis and resulted in healing of the retinal lesions. This case suggests that retrobulbar optic neuritis can be regarded as a prodrome of imminent acute retinal necrosis. Early recognition and prompt therapy with combined antivirals may prevent the development of this devastating ocular complication of varicella zoster infection.
Meenken
C
C
Department of Ophthalmology, Academic Medical Center, University of Amsterdam, The Netherlands.
van den Horn
G J
GJ
de Smet
M D
MD
van der Meer
J T
JT
D017088:AIDS-Related Opportunistic Infections / Q000821:virology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D014645:Herpesvirus 3, Human; D006801:Humans; D008297:Male; D009902:Optic Neuritis / Q000209:etiology* / Q000821:virology; D014792:Visual Acuity
D000998:Antiviral Agents; D017245:Foscarnet; D000212:Acyclovir