Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Feb 5;18(1):28.
doi: 10.1186/s12886-018-0696-3.

Varicella zoster virus-associated Chorioretinitis: a case report

Joo Yeon Kim  1   2 , Ji Hwan Lee  3 , Christopher Seungkyu Lee  1 , Sung Chul Lee  1
Affiliations
Case Reports

Varicella zoster virus-associated Chorioretinitis: a case report

Joo Yeon Kim et al. BMC Ophthalmol. .

Abstract

Background: Chorioretinitis is an unusual form of varicella zoster virus (VZV)-associated uveitis, and no report has described VZV-associated chorioretinitis using serial optical coherence tomography (OCT) images obtained during the course of resolution.

Case presentation: A 61-year-old woman presented with acute, unilateral vision loss in her right eye. Her visual acuity was count fingers in the right eye and 16/20 in the left eye, and she exhibited skin vesicles on her right forehead. Slit lamp biomicroscopy, funduscopy, OCT, and intraocular fluid analysis were performed. The right eye exhibited multiple inflammatory lesions at the posterior pole, macular edema, and disc swelling on the fundus examination. OCT revealed predominant involvement of the choroid and the retinal pigment epithelium (RPE). Intraocular fluid analysis showed positivity for VZV. The patient was admitted and treated with intravenous acyclovir. Additional oral prednisolone was used to reduce the inflammatory reaction. After 2 weeks of treatment with acyclovir, the lesion resolved, with undulation of the RPE. Her final visual acuity was 20/20.

Conclusions: VZV-associated posterior uveitis may present as multifocal chorioretinitis. Intraocular fluid analysis is important to detect an infectious origin.

Keywords: Chorioretinitis; Herpesvirus 3; Human; Uveitis.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of Severance hospital (IRB No.4–2017-0828) and was conducted in accordance with the Declaration of Helsinki. Consent to participate from the patients was waived by the Institutional Review Board of Severance hospital (IRB No.4–2017-0828) as this was a retrospective chart review study.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Imaging findings for a 61-year-old woman with varicella zoster virus-associated chorioretinitis. Multiple chorioretinal lesions can be observed superonasal to the fovea at the initial visit (a). Fluorescein and indocyanine green angiography findings in the late phase (b, c). Optical coherence tomography reveals hyper-reflective spots in the choroid layer and focal thickening of the choroid with an irregular overlying retinal pigment epithelium (d). Fundus photography and optical coherence tomographic images at 1 week after intravenous acyclovir treatment (e, f). The chorioretinal lesion and macular edema have resolved, although focal hypo-reflectivities observed on fundus autofluorescence remain because of atrophic changes at 2 weeks after intravenous acyclovir treatment (g–i)
See this image and copyright information in PMC

References

    1. Engstrom RE, Jr, Holland GN, Margolis TP, Muccioli C, Lindley JI, Belfort R, Jr, Holland SP, Johnston WH, Wolitz RA, Kreiger AE. The progressive outer retinal necrosis syndrome. A variant of necrotizing herpetic retinopathy in patients with AIDS. Ophthalmology. 1994;101(9):1488–1502. doi: 10.1016/S0161-6420(94)31142-0. - DOI - PubMed
    1. Margolis R, Brasil OF, Lowder CY, Smith SD, Moshfeghi DM, Sears JE, Kaiser PK. Multifocal posterior necrotizing retinitis. Am J Ophthalmol. 2007;143(6):1003–1008. doi: 10.1016/j.ajo.2007.02.033. - DOI - PubMed
    1. Wensing B, de Groot-Mijnes JF, Rothova A. Necrotizing and nonnecrotizing variants of herpetic uveitis with posterior segment involvement. Arch Ophthalmol. 2011;129(4):403–408. doi: 10.1001/archophthalmol.2010.313. - DOI - PubMed
    1. Bodaghi B, Rozenberg F, Cassoux N, Fardeau C, LeHoang P. Nonnecrotizing herpetic retinopathies masquerading as severe posterior uveitis. Ophthalmology. 2003;110(9):1737–1743. doi: 10.1016/S0161-6420(03)00580-3. - DOI - PubMed
    1. Meenken C, Rothova A. Varicella-zoster virus-associated multifocal chorioretinitis in 2 boys. JAMA Ophthalmol. 2013;131(7):969–970. doi: 10.1001/jamaophthalmol.2013.167. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources