VARICELLA-ZOSTER VIRUS RETROBULBAR OPTIC NEURITIS PRECEDING RETINITISIN PATIENTS WITH ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME

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.