Ms. Lee et al., VARICELLA-ZOSTER VIRUS RETROBULBAR OPTIC NEURITIS PRECEDING RETINITISIN PATIENTS WITH ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME, Ophthalmology, 105(3), 1998, pp. 467-471
Objective: This study aimed to describe a recently recognized and rare
presentation of varicella tester virus (VZV) retrobulbar optic neurit
is preceding retinitis in patients with acquired immune deficiency syn
drome and to identify factors that may relate to improved visual outco
me. Methods: Diagnosis, treatment, and clinical course are described f
or three eyes of two patients with this viral infection. Results: Pati
ents had decreased vision, headache, and recent tester dermatitis, Var
icella tester virus retrobulbar optic neuritis was diagnosed on the ba
ses of clinical, laboratory, and electrophysiologic examination result
s. Profound vision loss and peripheral retinitis ensued despite intrav
enous antiviral treatment. Combination intravenous and intravitreous a
ntiviral injections were administered with dramatic visual recovery. C
onclusions: Varicella tester virus retrobulbar optic neuritis should b
e considered in immunocompromised patients with visual loss. Early dia
gnosis and aggressive combination therapy via systemic and intravitreo
us routes may enable return of useful vision.