title: VZV multifocal vasculopathy with ischemic optic neuropathy, acute retinal necrosis and temporal artery infection in the absence of zoster rash.
abstract: We describe a 54-year-old diabetic woman who developed ischemic optic neuropathy followed by acute retinal necrosis and multiple areas of focal venous beading. Vitreous fluid contained amplifiable VZV DNA but not HSV-1, CMV or toxoplasma DNA. The clinical presentation was remarkable for jaw claudication and intermittent scalp pain, prompting a temporal artery biopsy that was pathologically negative for giant cell arteritis, but notable for VZV antigen. The current case adds to the clinical spectrum of multifocal VZV vasculopathy. The development of acute VZV retinal necrosis after ischemic optic neuropathy supports the notion that vasculitis is an important additional mechanism in the development of VZV retinal injury.
authors: Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
authors: Marc
authors: M
authors: Mathias
authors: Maria A
authors: MA
authors: Nagel
authors: Nelly
authors: N
authors: Khmeleva
authors: Philip J
authors: PJ
authors: Boyer
authors: Alexander
authors: A
authors: Choe
authors: Vikram D
authors: VD
authors: Durairaj
authors: Jeffrey L
authors: JL
authors: Bennett
authors: Naresh
authors: N
authors: Mandava
authors: Don
authors: D
authors: Gilden
mesh_terms: D005076:Exanthema; D005260:Female; D006562:Herpes Zoster / Q000150:complications / Q000175:diagnosis*; D014645:Herpesvirus 3, Human; D006801:Humans; D018917:Optic Neuropathy, Ischemic / Q000150:complications / Q000175:diagnosis*; D015882:Retinal Necrosis Syndrome, Acute / Q000150:complications / Q000178:diet therapy*; D013699:Temporal Arteries / Q000473:pathology / Q000821:virology*