acyclovir and Retinal-Vasculitis

Topics: Acyclovir; Antiviral Agents; Chickenpox; Humans; Retinal Vasculitis

A 4-year-old girl presented with acute left visual loss 4 weeks after uneventful chickenpox. She was found to have left necrotising retinitis and profound retinal vasculitis and vitritis. Aqueous humour was PCR positive for varicella-zoster virus. Combined intravenous and intravitreal antiviral treatment led to rapid improvement with settled retinitis, no vascular occlusion and good recovery of vision. Her recent coinfection with Epstein-Barr virus may have acted to provoke the retinitis.

Topics: Acyclovir; Antiviral Agents; Aqueous Humor; Chickenpox; Child, Preschool; Female; Herpes Zoster Ophthalmicus; Humans; Panuveitis; Retinal Necrosis Syndrome, Acute; Retinal Vasculitis; Treatment Outcome; Vision Disorders

Dyskeratosis congenita (DC) is an inherited bone marrow failure syndrome, usually presented with abnormal skin pigmentation, nail dystrophy, and oral leukoplakia. The main cause of mortality in DC is immunodeficiency and vital infection. DC involves multisystem, but retinal involvements are rare.Herein, we report an unusual case of pediatric DC suffering from frosted branch angiitis (FBA) after recovery of mycoplasma pneumonia. Cytomegalovirus infection and cytokine changes were found relevant to the onset of FBA. Despite corticosteroids, antiviral medication, and hematopoietic stem cell transplantation, the patient ended in poor vision with optic atrophy.This case implies that pediatricians should be aware of FBA as a rare retinal manifestation in children with DC and bone marrow failure. Cytomegalovirus may be one of the common causes and cytokines could be triggering factors.

Topics: Acyclovir; Anemia, Aplastic; Bone Marrow Diseases; Bone Marrow Failure Disorders; Child; Combined Modality Therapy; Cord Blood Stem Cell Transplantation; Dyskeratosis Congenita; Fluorescein Angiography; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; Hemoglobinuria, Paroxysmal; Humans; Male; Methylprednisolone; Opportunistic Infections; Optic Atrophy; Pneumonia, Mycoplasma; Retinal Vasculitis; Retinal Vessels; Tomography, Optical Coherence

Topics: Acute Disease; Acyclovir; Antiviral Agents; Child; Female; Fluorescein Angiography; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Immunocompromised Host; Recurrence; Retinal Vasculitis; Uveitis, Anterior; Virus Activation; Visual Acuity

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.

Topics: Acyclovir; Antiviral Agents; Aqueous Humor; Child; DNA, Viral; Drug Administration Routes; Eye Infections, Viral; Female; Ganciclovir; Herpesvirus 3, Human; Humans; Photophobia; Polymerase Chain Reaction; Retinal Vasculitis; Treatment Outcome; Valacyclovir; Valine; Vision, Low

Topics: Acyclovir; Aged; Antihypertensive Agents; Antiviral Agents; DNA, Viral; Drug Therapy, Combination; Glucocorticoids; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Male; Middle Aged; Polymerase Chain Reaction; Prednisolone; Retinal Vasculitis; Timolol; Uveitis, Anterior; Vitreous Body

A case of acute severe loss of vision due to perivasculitis typical of frosted retinal branch angiitis due to Herpes simplex virus in an otherwise healthy young Omani lady is presented.

Topics: Acyclovir; Administration, Oral; Adrenal Cortex Hormones; Adult; Antibodies, Viral; Antiviral Agents; Drug Therapy, Combination; Eye Infections, Viral; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Herpes Simplex; Humans; Immunocompetence; Immunoglobulin M; Infusions, Intravenous; Retinal Vasculitis; Simplexvirus