Central Retinal Artery Occlusion Associated with Varicella dermatitis

Agarwal, Lalit; Agrawal, Nisha; Labh, Rajan Kumar; Choubey, Rahul; Agrawal, B A Shruti

doi:10.3126/jnps.v36i1.14876

Cited by 3 publications

(14 citation statements)

References 9 publications

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“…Sebban AI et al [4] have also reported a similar case with a branch retinal artery following varicella zoster eruptions. Lalit et al [7] from our region have also reported a case of CRAO with a profound vision loss in a 12-year-old patient who presented within few days after varicella zoster infection with dermatitis causing a profound vision loss.…”

Section: Discussionmentioning

confidence: 78%

“…Other mechanisms are also known and mainly include exogenous emboli, thrombotic, vasospastic, and vasculitic pathologies [9]. Retinal artery occlusion has been reported as a complication of varicella-zoster infection in various age groups denoting vaso-occlusive nature of pathology [3–5, 7, 10]. It is also one of the components of the varicella vasculopathy [5].…”

Section: Discussionmentioning

confidence: 99%

“…Most literatures [2, 3, 7, 10, 13, 14] agree that retinal complications can be treated or prevented with the use of Acyclovir. The patient was already under treatment of this drug and was advised to continue the medication.…”

Section: Discussionmentioning

confidence: 99%

“…Ocular manifestations of the pathology have been reported in forms of retinal vasculopathy, retinitis, and optic neuritis [3–7]. Cilioretinal artery occlusion in the pediatric population is considered very rare and it is most often associated with hypercoagulable states and embolic phenomena [8].…”

Section: Introductionmentioning

confidence: 99%

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Varicella Retinal Vasculopathy: Unilateral Cilioretinal Artery Occlusion Despite Acyclovir Therapy Caught Using Optical Coherence Tomography-Angiography (OCTA)

Khatri

Timalsena

Gautam

et al. 2019

Case Reports in Ophthalmological Medicine

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Varicella zoster is known to be associated with vaso-occlusive pathologies, vasculitis, or optic neuritis, leading to profound visual loss. We report a case where a 13-year-old boy who initially presented to us with on and off diminution of vision in his right eye since 3 days and had normal ocular and OCT angiography findings followed up in 5 days with sudden painless diminution of vision in the same eye since one day this time revealing a pale macular region with rest of the retina being normal. Repeated OCT angiography showed loss of the capillary network around the perifoveal region suggesting cilioretinal artery occlusion.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Varicella Retinal Vasculopathy: Unilateral Cilioretinal Artery Occlusion Despite Acyclovir Therapy Caught Using Optical Coherence Tomography-Angiography (OCTA)

Khatri

Timalsena

Gautam

et al. 2019

Case Reports in Ophthalmological Medicine

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“…On examination the best-corrected visual acuity (BCVA) in the affected eye ranges from 20/40 to no light perception (LP). Relative afferent pupillary defects (RAPD) have been positive in three cases [19,22,26].…”

Section: Key Pointsmentioning

confidence: 99%

Retinal vasculopathy following varicella zoster virus infection

Sutra

Pokawattana

2022

Current Opinion in Ophthalmology

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Purpose of reviewVaricella zoster virus (VZV) ocular infection can manifest purely as a vasculopathy that leads to retinal arteriole occlusion, without any retinitis or vasculitis. This review summarizes our current knowledge of such VZV ocular infection phenotype, incorporating initial descriptions from 1988. We describe the pathogenesis and VZV's manifestations in the retina using fundus photography, fundus fluorescein angiography, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Laboratory investigations, diagnostic procedures, prognoses, and treatment options are also being reviewed.Recent findingsTen case reports where VZV retinal vasculopathy was the primary feature observed after varicella or zoster rash are described. The retinal arteriole, cilioretinal artery, branches of retinal artery, central retinal artery and ophthalmic artery were found to be areas of more rarely affected, neither in the form of vasculitis nor retinitis. Diagnosis is typically made from positive polymerase chain reaction (PCR) for VZV from extracted intraocular fluid or positive serum or cerebrospinal fluid (CSF) anti-VZV immunoglobulin G antibody in the context of compatible ocular findings. In addition, retinal vasculopathy occurring in the setting of confirmed varicella or zoster rashes could be considered potentially pathognomonic. Pathological concepts, including direct VZV infection of affected tissue, persistent inflammation, and/or virus-induced hypercoagulability are also discussed.SummaryVZV may produce a wide spectrum of ocular manifestations with isolated VZV retinal vasculopathy being a rarer presentation. A prompt diagnosis followed by an early treatment of systemic acyclovir with or without corticosteroids is the mainstay of treatment.

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