A case report of Epstein–Barr virus-associated retinal vasculitis: successful treatment using only acyclovir therapy

Abstract

The purpose of this study was to describe a presumed case of Epstein–Barr virus (EBV)-associated retinal vasculitis in a 42-year-old female with sudden unilateral vision loss and successful treatment with acyclovir therapy. Diagnostic vitreous biopsy of the right eye was performed to test for EBV and other known infectious causes of retinitis and evaluate vitreous cells and serological testing. Vitreous polymerase chain reaction viral DNA testing result was positive for EBV but negative for herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Serologic testing was negative for toxoplasma gondii, syphilis, tuberculosis, and HIV. Histopathologic analysis of vitreous cells revealed atypical lymphocytes. Fluorescein angiography showed disk leakage, occluded retinal artery, peripheral vascular leakage, and ischemic area of the right eye. Intravenous acyclovir, 10 mg/kg/d, was prescribed for 14 days followed by oral acyclovir for 3 months. All lesions have become quiet. EBV may be a cause of retinal disease, and intravenous acyclovir is a successful treatment choice.

Acute Acalculous Cholecystitis Associated with Epstein–Barr Infection: A Case Report and Review of the Literature

“…An adequate number of vasculitis reports caused by EBV infection are identified in the literature [46][47][48][49][50][51]. It is interesting that some of these cases represent localized forms of vasculitis affecting only a single organ.…”

Viral retinitis: diagnosis and management in the era of biologic immunosuppression: A review

“…It has been identified using PCR from the ocular fluids of eyes with anterior uveitis, vitritis, vasculitis and retinitis, and in 70% of normal cadaveric eyes . Reports have also identified its presence in eyes with ARN, mostly concomitantly with HSV or VZV, though there have also been cases where it was the only identified pathogen . Schaal et al demonstrated EBV DNA in the retinal cells of a patient with ARN, supporting its role in disease rather than as an indicator of lymphocyte migration.…”

“…Treatment is based on a similar protocol to other causes of ARN, and reports have suggested a good response to the use of systemic and intravitreal aciclovir (Table ) …”

“…11,18,20,[143][144][145] Reports have also identified its presence in eyes with ARN, mostly concomitantly with HSV or VZV, 10,12 though there have also been cases where it was the only identified pathogen. 20,21,145 Schaal et al demonstrated EBV DNA in the retinal cells of a patient with ARN, supporting its role in disease rather than as an indicator of lymphocyte migration. Treatment is based on a similar protocol to other causes of ARN, and reports have suggested a good response to the use of systemic and intravitreal aciclovir (Table 2).…”

“…Treatment is based on a similar protocol to other causes of ARN, and reports have suggested a good response to the use of systemic and intravitreal aciclovir (Table 2). 20,145 11 | BIOLOGIC THERAPY AND VIRAL RETINITIS Immunosuppressive medications are widely used to treat a range of inflammatory conditions and use is likely to increase with the advent of more and newer therapies. Biologic agents are a broad category encompassing all products derived partly or completely from an organic source.…”