acyclovir and Ocular-Hypertension

Topics: Acyclovir; Antihypertensive Agents; Antiviral Agents; Aqueous Humor; Eye Infections, Viral; Herpes Simplex; Herpesvirus 1, Human; Humans; Intraocular Pressure; Lens Implantation, Intraocular; Male; Middle Aged; Ocular Hypertension; Phacoemulsification; Polymerase Chain Reaction; Uveitis; Virus Activation

A 63-year-old man with HZO presented with involvement of cranial nerves II, III, IV, V, and VI, with proptosis, raised intraocular pressure, and chemosis. With the aid of orbital imaging, a diagnosis of orbital apex inflammation secondary to HZO was confirmed, and he was treated with intravenous acyclovir and oral steroids. Despite this, he made a minimal recovery at eight months following presentation. Severe, irreversible orbital disease may develop following HZO, and an ischemic vasculitis may play a role in the pathogenesis of the disease.

Topics: Acyclovir; Antiviral Agents; Blepharoptosis; Conjunctival Diseases; Drug Therapy, Combination; Edema; Exophthalmos; Glucocorticoids; Herpes Zoster Ophthalmicus; Humans; Infusions, Intravenous; Intraocular Pressure; Magnetic Resonance Imaging; Male; Middle Aged; Ocular Hypertension; Orbital Diseases; Prednisolone; Tomography, X-Ray Computed

To report a case of zoster sine herpete with bilateral ocular involvement.. Case report.. A 65-year-old man showed bilateral iridocyclitis with sectoral iris atrophy and elevated intraocular pressure unresponsive to steroid treatment. No cutaneous eruption was manifest on the forehead. A target region of varicella-zoster virus DNA sequence was amplified from the aqueous sample from the left eye by polymerase chain reaction. Bilateral iridocyclitis resolved promptly after initiation of systemic and topical acyclovir treatment. Secondary glaucoma was well controlled by bilateral trabeculectomy.. Zoster sine herpete should be considered and polymerase chain reaction performed on an aqueous sample to detect varicella-zoster virus DNA for rapid diagnosis whenever anterior uveitis accompanies the characteristic iris atrophy, even in the case of bilateral involvement.

Topics: Acyclovir; Aged; Antiviral Agents; Atrophy; DNA Primers; DNA, Viral; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Intraocular Pressure; Iridocyclitis; Iris; Male; Ocular Hypertension; Polymerase Chain Reaction; Trabeculectomy; Visual Acuity