VZV retinal vasculitis without systemic infection: diagnosis and monitoring with quantitative polymerase chain reaction

Abstract

To report a case of unilateral varicella zoster virus (VZV) retinal vasculitis aspect in an immunocompetent child without systemic infection. Clinically, no signs of retinal necrosis or frosted branch vasculitis were present. This is an observational case report. Quantitative PCR was performed on the aqueous humor (AH) using primers specific for herpes virus (cytomegalovirus, Epstein-Barr virus, herpes simplex virus 1-2, and VZV). The patient was treated with intravenous acyclovir, intravitreous ganciclovir, and oral valacyclovir. A positive quantitative PCR result was found for VZV DNA (1.72 x 10(6) viral copies/ml) in the AH. After 6 months, PCR of the AH was negative. Herpes viruses are involved in the pathogenesis of isolated retinal vasculitis. This case demonstrates that quantitative PCR is useful to detect viral DNA in AH and to monitor the viral activity and the therapeutic response.

Anterior uveitis and vasculitis in primary infection with VZV in a diabetic patient

“…Reviewing the literature, we have seen that both anterior uveitis and retinal vasculitis are rare in the context of VZV primary infection [8,9].…”

“…Anterior uveitis and retinal involvement are more frequent during the reactivations of the disease [6][7][8][9].…”

Ganciclovir-Resistant Cytomegalovirus (CMV) Retinitis in a Patient with Wild-Type CMV in Her Plasma

“…For our patient, we performed quantitative real-time PCR on aqueous humor to monitor our patient's disease progression, similar to previous reports of quantitative PCR in the evaluation and monitoring of other intraocular viral infections (6,8,9,13). Primers and probes used were previously described by Sanchez and Storch (12).…”