[Scleromalacia associated with varicella-zoster virus].
BACKGROUND
Scleromalacia usually appears following vasculitis in systemic rheumatoid diseases, especially as a late symptom of rheumatoid arthritis.


METHODS
A 67-year-old woman was referred to our hospital for further evaluation with the diagnosis of a "fast-growing tumor" of the left eye. Sixteen months ago she had suffered from herpes zoster ophthalmicus-associated keratouveitis and trabeculitis in the same eye. Scleromalacia associated with varicella-zoster virus (VZV) was diagnosed after the biomicroscopic and gonioscopic examination of the eye was completed and a systemic disease had been ruled out. One week after beginning systemic application of acyclovir (5 x 800 mg daily) and prednisolone (30 mg daily), the anterior chamber inflammation regressed and a fibrosis seemed to appear in the atrophic scleral area.


CONCLUSIONS
Although scleral atrophy mostly appears as a late sign of systemic rheumatoid diseases, it might also develop secondary to infectious diseases. Scleromalacia associated with varicella-zoster virus has been previously described only in a few cases. Scleromalacia is a vision-threatening complication of zoster ophthalmicus which responds well to combination therapy with systemic antiviral and anti-inflammatory agents.
Yoeruek
E
E
Abteilung I, Universitätsaugenklinik der Eberhard-Karls-Universität Tübingen, Schleichstrasse 12, 72076 Tübingen. Efdal.Yoeruek@med.uni-tuebingen.de
Deuter
C M E
CM
Szurman
P
P
Tatar
O
O
Zierhut
M
M
D000212:Acyclovir / Q000008:administration & dosage; D000284:Administration, Oral; D000287:Administration, Topical; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage; D001284:Atrophy; D004359:Drug Therapy, Combination; D005130:Eye Hemorrhage / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005355:Fibrosis; D005654:Fundus Oculi; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008134:Long-Term Care; D009887:Ophthalmoscopy; D011239:Prednisolone / Q000008:administration & dosage; D012008:Recurrence; D012590:Sclera / Q000187:drug effects / Q000473:pathology; D015422:Scleral Diseases / Q000175:diagnosis* / Q000188:drug therapy; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D011239:Prednisolone; D000212:Acyclovir