Optic Chiasm, Optic Nerve, and Retinal Involvement Secondary to Varicella-zoster Virus

Abstract

mmunocompromised patients are known to be at risk for varicella-zoster virus reactivation, often in atypical manners. We describe a 30-year-old man with simultaneous involvement of the retina, optic chiasm, and optic nerve with varicella-zoster virus who had a bitemporal visual field defect.

Unilateral retrobulbar optic neuritis due to varicella zoster virus in a patient with AIDS: A case report and review of the literature

“…To date, only 5 cases of isolated retrobulbar optic neuritis, without skin or retinal lesions, secondary to VZV infection have been reported in the literature [2,7,22]. We believe that our case is the sixth.…”

“…Patients who are immunocompromised are particularly susceptible, and VZV infection can frequently occur without a typical cutaneous dermatomal eruption. Simultaneous involvement of the retina and optic nerve from VZV in acute retinal necrosis syndrome is well documented [7,21]. In contrast, primary infection of the optic nerve is uncommon, and VZVrelated isolated retrobulbar optic neuritis is rare (Table 1).…”

Chiasmal optic neuritis following mumps parotitis

“…Chiasmal optic neuritis, a rare disorder involving the optic chiasma, occurs in autoimmune demyelinating disorders, and may be the initial manifestation of MS [5,6]. Chiasmal optic neuritis is also caused by systemic lupus erythematosus [7], sarcoidosis [8], and neuronal infections [9][10][11][12]. Our patient had no inflammatory findings in the CSF, but several clinical features suggested a postinfectious, autoimmune mechanism as the cause: (1) a chiasmal inflammatory lesion on MRI (although LHON can cause a similar MRI finding [13]); (2) a therapeutic response to corticosteroids; (3) the absence of findings indicative of systemic autoimmune diseases; (4) the temporal relationship between the chiasmal disease and the serologically proven mumps parotitis.…”

Central and Paracentral Visual Field Defects and Driving Abilities

“…Although PCS have been reported in infections with herpes viridae, AIDS, Lyme disease and secondary syphilis, they are almost always monocular and, with the exception of AIDS, progression is now rare [8, 28, 35, 57, 67, 102, 113, 124, 133, 148, 219]. The implications for driving have not been studied.…”