A Case of Optic Neuritis Complicating Herpes Zoster Ophthalmicus in a Child

Hong, Seong Min; Yang, Yun Sik

doi:10.3341/kjo.2010.24.2.126

Cited by 10 publications

(12 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lymphocytic infiltration occurs along the posterior ciliary vessels and nerves causing occlusive vasculitis and ischaemic injury 11. An alternative mechanism of injury can be caused by lymphocytic infiltration of the orbital nerves via sensory offshoots of trigeminal nerve to the motor cranial nerves 12.…”

Section: Discussionmentioning

confidence: 99%

Orbital apex syndrome as a complication of herpes zoster ophthalmicus

et al. 2017

View full text Add to dashboard Cite

Orbital apex syndrome is a rare neuro-ophthalmic manifestation of herpes zoster virus infection. We report one such case with favourable outcome in an immunocompetent patient. A 60-year-old woman presented with rash in the dermatome of the left ophthalmic nerve (V1), followed by sudden loss of vision with complete left-sided external and internal ophthalmoplegia. MRI of brain and orbits with contrast revealed optic perineuritis and myositis without intracranial involvement confirming the diagnosis of orbital apex syndrome. Functional visual recovery was achieved after a course of intravenous and oral steroids under antiviral cover over a follow-up period of 3 months.

show abstract

Section: Discussionmentioning

confidence: 99%

Orbital apex syndrome as a complication of herpes zoster ophthalmicus

et al. 2017

View full text Add to dashboard Cite

show abstract

“… 3 There are also some case reports of VZV optic neuritis after herpes zoster ophthalmicus. 4 5 6 Cases of VZV posterior segment infection have been reported in AIDS patients, 7 8 9 although it is uncommon in healthy adults.…”

Section: Discussionmentioning

confidence: 99%

“… 12 Recent case reports have shown better visual outcomes when systemic acyclovir and steroids are prescribed. 5 6 MacKinnon et al 2 reported a case of VZV neuroretinitis in a 9-year-old child. The patient had blurred vision of the right eye with a VA of 0.01, after an episode of varicella.…”

Section: Discussionmentioning

confidence: 99%

Varicella zoster virus-associated neuroretinitis

Tsao

Tsai

2015

Taiwan Journal of Ophthalmology

View full text Add to dashboard Cite

Varicella zoster virus-associated neuroretinitis is rare. We report a patient who presented with blurred vision of the left eye and extraocular movement pain. A fundoscopic examination revealed disc edema, hyperemia, and macular edema. The impression was neuroretinitis. Intravenous methylprednisolone pulse therapy was administered. However, visual recovery was incomplete with optical coherence tomography (OCT) imaging showing photoreceptor layer disruption. The laboratory data were rechecked and demonstrated a high varicella zoster virus immunoglobulin G titer. Varicella zoster virus-associated neuroretinitis was suspected and oral acyclovir was prescribed. His visual acuity improved to 0.9 after 2 weeks of treatment, and OCT showed photoreceptor layer restoration. Spectrum-domain OCT provides useful information when evaluating the disease course of neuroretinitis.

show abstract

“…The degree of visual loss varies, ranging from mild to severe visual impairment [ 6 – 12 ]. Adults, especially the elderly, are more affected; however, HZO-related ON in children has also been reported [ 9 , 13 ]. HZO-related ON in many previous reports was found simultaneously with other ocular complications, such as anterior uveitis, keratitis, and secondary glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Isolated optic neuritis with a concurrent abnormal trigeminal nucleus on imaging: case report of a rare complication of herpes zoster ophthalmicus

et al. 2018

View full text Add to dashboard Cite

BackgroundHerpes zoster ophthalmicus (HZO) is an inflammation related to reactivation of the latent varicella zoster virus (VZV), involving the ophthalmic branch of the trigeminal nerve. Optic neuritis (ON), a rare ocular complication following HZO, has been reported in 1.9% of HZO-affected eyes. Most previous cases occurred simultaneously with other ocular complications, especially orbital apex syndrome. Moreover, detailed magnetic resonance imaging (MRI) with diffusion weighted imaging of the optic nerve and trigeminal nucleus in HZO-related ON has been rarely reported. We report a case of postherpetic isolated ON with a concurrent abnormal trigeminal nucleus on imaging.Case presentationA healthy 58-year-old female presented with sudden painful visual loss in her right eye for 2 days. Four weeks before the presentation, her right eye was diagnosed with HZO, and she received intravenous acyclovir for 10 days. Ophthalmic examination revealed a visual acuity of light perception and 20/20 in the right and left eyes, respectively. A relative afferent pupillary defect was present in the right eye. Neurological examination was significant for hypoesthesia in the area of the HZO. A clinical diagnosis of HZO-related right retrobulbar ON was made, and other causes of atypical ON were excluded. MRI showed enhancement and restricted diffusion of the right-sided optic nerve with linear hyperintense T2 of the right-sided spinal trigeminal nucleus and tract (STNT) along the brainstem. She received 14 days of intravenous acyclovir and 5 days of methylprednisolone. Both were switched to an oral route for 2 months. After the completion of treatment, the visual acuity was counting fingers and 20/20 in the right eye and left eye, respectively. Stable brainstem STNT abnormalities and resolution of ON were found radiologically.ConclusionsIsolated ON is a rare ocular complication following HZO. An abnormal high signal of STNT on a T2 weighted image may be present, which may be a clue for VZV-associated complications, such as HZO-related ON, especially in cases lacking an obvious history of HZO or other concomitant ocular complications. Prompt treatment with both acyclovir and corticosteroids should be started. Restricted diffusion of the optic nerve may be a predictor for poor visual recovery.

show abstract

A Case of Optic Neuritis Complicating Herpes Zoster Ophthalmicus in a Child

Cited by 10 publications

References 25 publications

Orbital apex syndrome as a complication of herpes zoster ophthalmicus

Orbital apex syndrome as a complication of herpes zoster ophthalmicus

Varicella zoster virus-associated neuroretinitis

Isolated optic neuritis with a concurrent abnormal trigeminal nucleus on imaging: case report of a rare complication of herpes zoster ophthalmicus

Contact Info

Product

Resources

About