1/66. zoster sine herpete with bilateral ocular involvement.PURPOSE: To report a case of zoster sine herpete with bilateral ocular involvement. METHOD: Case report. RESULTS: 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. CONCLUSIONS: 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.- - - - - - - - - - ranking = 1keywords = virus (Clic here for more details about this article) |
2/66. Acute retinal necrosis following contralateral herpes zoster ophthalmicus.BACKGROUND: A case report of contralateral acute retinal necrosis (ARN) following herpes zoster ophthalmicus. CASE: A 61-year-old male patient developed iridocyclitis and well-demarcated creamy-white retinal lesions at the nasal periphery in the right eye 1 month after herpes zoster ophthalmicus in the left eye. The patient had undergone surgery for primary lung cancer, and had subsequent intracranial metastasis of the tumor. OBSERVATIONS: The clinical diagnosis of ARN was supported by polymerase chain reaction investigation of the aqueous humor resulting in positive for varicella-zoster virus. Retinal lesions disappeared after systemic treatment with acyclovir, corticosteroids, and acetylsalicylate. No retinal detachment developed. CONCLUSIONS: We propose a careful ophthalmic follow-up for herpes zoster ophthalmicus patients because of the possibility of acute retinal necrosis developing in the contralateral eye.- - - - - - - - - - ranking = 0.5keywords = virus (Clic here for more details about this article) |
3/66. optic chiasm, optic nerve, and retinal involvement secondary to varicella-zoster virus.Immunocompromised patients are known to be at risk for varicella-zoster virus reactivation, often in atypical manners. We describe a 30-year-old man with simultaneous involvement of the retina, optic chiasm, and optic nerve with varicella-zoster virus who had a bitemporal visual field defect.- - - - - - - - - - ranking = 3keywords = virus (Clic here for more details about this article) |
4/66. Central retinal vein occlusion due to herpes zoster as the initial presenting sign in a patient with acquired immunodeficiency syndrome (AIDS).Central retinal vein occlusion (CRVO) due to herpes zoster has rarely been reported. Varicella zoster virus is a common opportunistic infection in patients with AIDS. This case report is about a 40-year-old man with herpes zoster ophthalmicus and central retinal vein occlusion of the right eye who is hiv-positive. Although the lesion resolved following treatment with intravenous acyclovir and oral steroid, the patient subsequently developed florid disc neovascularization and vitreous hemorrhage. The paper highlights CRVO as the initial presentation in an AIDS patient with herpes zoster ophthalmicus.- - - - - - - - - - ranking = 0.5keywords = virus (Clic here for more details about this article) |
5/66. Failure of antiretroviral therapy to control Varicella zoster retinitis.The term necrotizing herpetic retinopathies encompasses a spectrum of diseases which includes cytomegalovirus (CMV) retinitis, acute retinal necrosis (ARN) and Varicella zoster retinitis (VZR). Varicella zoster retinitis is a rapidly progressive, necrotizing condition most commonly reported in patients with AIDS. A case of vitreous biopsy-proven VZR is reported in a patient with AIDS that progressed despite immune recovery on highly active antiretroviral therapy (HAART) to a viral load < 50 copies/mL and a CD4 count of 230 cells/microL. This is in contrast to CMV retinitis in which maintenance therapy appears unnecessary once the CD4 count rises and the viral load falls on HAART. patients with VZR and AIDS should therefore be monitored for reactivation of retinal disease despite HAART-induced remission.- - - - - - - - - - ranking = 0.5keywords = virus (Clic here for more details about this article) |
6/66. Varicella-zoster viral antigen identified in iridocyclitis patient.BACKGROUND: The varicella-zoster virus (VZV) antigen has not been identified immunohistologically in iridocyclitis due to VZV. CASE: A 65-year-old woman diagnosed with iridocyclitis and secondary glaucoma underwent trabeculectomy. Samples of aqueous humor and juxtacanalicular and iris tissue were obtained for immunohistological and polymerase chain reaction (PCR) study. OBSERVATIONS: Slit-lamp microscopy revealed ciliary injection, corneal epithelial edema, mutton fat precipitates, flare, cells, and progressive iris atrophy in the right eye. Subsequently, scant eruptions on her right upper eyelid appeared and disappeared within a week. Although a diagnostic increase in the complement fixation antibody titer to VZV was not observed, we started medical treatment for VZV, on suspicion of iridocyclitis due to VZV. Despite medical treatment, the ratio of peripheral anterior synechia was greater than 60% and iris atrophy progressed in parallel. The intraocular pressure in the right eye remained above 30 mm Hg at 6 months after the first visit, so trabeculectomy was performed. VZV-specific dna was detected in the aqueous humor by the PCR study. Immunohistological examination demonstrated numerous VZV antigen-positive cells in the iris stroma, in particular, vascular endothelial cells. CONCLUSION: To our knowledge, this is the first report of the detection of VZV antigen in the iris of an iridocyclitis patient.- - - - - - - - - - ranking = 0.5keywords = virus (Clic here for more details about this article) |
7/66. Granulomatous angiitis of the central nervous system associated with herpes zoster.Granulomatous angiitis of central nervous system (CNS) is a rare inflammatory disease of blood vessels mostly confined to CNS. We describe a case which presented with right sided hemiplegia with aphasia, after herpes zoster ophthalmicus. CT scan and MRI brain showed a large left sided infarct in the left middle cerebral artery (MCA) territory. MRI angiography revealed narrowing and thinning of left internal carotid artery (ICA) and to a lesser extent, left MCA suggestive of granulomatous vasculitis. Herpes zoster is often associated with major CNS involvement and a vascular etiology was previously postulated. Recent pathological reports suggest that cerebral angiitis secondary to herpes virus infection may be more common than realised.- - - - - - - - - - ranking = 0.5keywords = virus (Clic here for more details about this article) |
8/66. herpes zoster ophthalmicus: how is it identified and treated?PURPOSE: To describe herpes zoster ophthalmicus in relation to the anatomy, pathophysiology, course, diagnostic considerations, and management for the primary care provider. DATA SOURCES: Actual case study supplemented with an extensive review of current scientific and psychosocial literature. CONCLUSIONS: herpes zoster ophthalmicus (HZO) is an extension of a herpes zoster (HZ) infection involving the fifth cranial (trigeminal) nerve, which results from the reactivation of a latent varicella virus among individuals who had contracted a varicella infection sometime within their lifespan. IMPLICATIONS FOR PRACTICE: Due to the vague presenting symptomology of HZO, many patients may be misdiagnosed lessening the chance for prompt diagnosis and therapeutic intervention. Educational awareness, listening to psychosocial concerns of the patients, and immediate referral can decrease potential chronic side effects of the disorder.- - - - - - - - - - ranking = 0.5keywords = virus (Clic here for more details about this article) |
9/66. Corneal epithelial keratitis in herpes zoster ophthalmicus: "delayed" and "sine herpete". A non-contact photomicrographic in vivo study in the human cornea.PURPOSE: To investigate the origin of corneal epithelial keratitis occurring without accompanying herpes zoster ophthalmicus (HZO) cutaneous rash. methods: Corneal epithelial lesions in seven patients (four with a history of classical HZO with cutaneous rash, one of herpes zoster oticus, and two with no history of herpes zoster, were examined with the slit lamp and photographed by non-contact in vivo photomicrography. The findings were compared with lesions in classical acute HZO. polymerase chain reaction (PCR) was done in three patients. RESULTS: Slit lamp appearance, morphology at higher magnification, and kinetics of the lesions were indistinguishable from classical acute HZO. PCR was positive for varicella-zoster virus dna in all three samples. CONCLUSIONS: The findings strongly suggest that HZO typical corneal epithelial lesions occurring in the absence of cutaneous rash are in fact recurrent episodes of virus shedding.- - - - - - - - - - ranking = 1keywords = virus (Clic here for more details about this article) |
10/66. herpes zoster ophthalmicus.BACKGROUND: We examined the literature for the latest information on diagnosis and management of herpes zoster, and compiled a representative database. methods: Using search engines and library resources, we reviewed pathology, epidemiology, pathophysiology, differential diagnosis, and management. RESULTS: The varicella zoster virus is a member of the herpes virus family that produces an infection through direct contact with active skin lesions or airborne droplets. The infection resides latent in the trigeminal ganglion until reactivated, often affecting the sensory nerve, skin, eye, and adnexa. CONCLUSION: The varicella zoster virus has the potential to severely disrupt the structures of the eye. patients less than 50 years of age should be referred for systemic workup to rule out an immunocompromised state. In general, management is often palliative and/or geared toward specific sequelae.- - - - - - - - - - ranking = 1.5keywords = virus (Clic here for more details about this article) |
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