Herpes zoster ophthalmicus, central retinal artery occlusion, and neovascular glaucoma in an immunocompetent individual

Abstract

Purpose: To report the unusual case of an immunocompetent individual with herpes zoster ophthalmicus who developed central retinal artery occlusion and subsequent neovascular glaucoma. Case Report: A 40-year-old, immunocompetent patient was diagnosed with herpes zoster ophthalmicus and central retinal artery occlusion on initial presentation. Subsequently, he developed neovascular glaucoma. Conclusion: There are a few case reports of central retinal artery occlusion developing after varicella zoster virus infection. However, a literature search found no reports of neovascular glaucoma following central retinal artery occlusion secondary to varicella zoster virus infection. The present case report indicates that neovascular glaucoma is a possible complication in such a scenario.

Oral Valacyclovir Treatment of Herpes Zoster Ophthalmicus-Induced Optic Neuritis

“…HZO is a manifestation of the herpes zoster virus, present in roughly 20% of all herpes zoster cases, that affects the periorbital region and the trigeminal nerve (V1) dermatome distribution [ 2 , 3 ]. Without adequate and effective treatment, HZO can persist with associated vision loss, glaucoma, central retinal artery occlusion, dendritic keratitis, corneal anesthesia, secondary infection, stromal neovascularization, corneal opacity, chronic granulomatous uveitis, iris atrophy, scleritis, and acute retinal necrosis [ 2 , 3 , 5 ]. However, the most debilitating complication of HZO is postherpetic neuralgia (PHN), a neuropathic pain syndrome that persists after the zoster rash has resolved [ 1 ].…”

Herpes zóster oftálmico, complicación del virus herpes zóster

“…Se recomienda el uso de antivirales orales durante 7 a 10 días como por ejemplo aciclovir 800 mg cada 4 horas o, valaciclovir 1 g cada 8 horas o, famciclovir 500 mg cada 8 horas. Además, se debe de complementar con aciclovir tópico al 3% 1 aplicación cada 4 horas (1,10,11,17). Se debe considerar el uso de aciclovir intravenoso en personas con VIH / SIDA para reducir los riesgos de diseminación de la infección por varicela zóster (4).…”

“…La queratitis dendrítica y la uveítis pueden indicar actividad crónica del virus. El tratamiento de la queratitis es con aciclovir tópico al 3% o ganciclovir al 0,15%, cinco veces al día por al menos 5 días (4,17). Las lágrimas artificiales garantizan la integridad de la superficie ocular en casos de queratitis neurotrófica (1).…”