1/68. Coxsackievirus B4 as a cause of adult chorioretinitis.PURPOSE: To describe the clinical manifestation and course of chorioretinitis presumed to be secondary to coxsackievirus infection in an adult. METHOD: Case report documented by fundus photography and fluorescein angiography. RESULTS: Ophthalmoscopic examination of a symptomatic 34-year-old woman showed several cream-colored parafoveal spots at the level of the retinal pigment epithelium and similar, multiple confluent spots in the midperiphery of both eyes. Titers for coxsackievirus B4 demonstrated a fourfold rise between acute and convalescent sera. CONCLUSION: Coxsackievirus B4 is apparently a rare cause of chorioretinitis but nevertheless should be considered in the appropriate clinical setting.- - - - - - - - - - ranking = 1keywords = retinitis (Clic here for more details about this article) |
2/68. central serous chorioretinopathy and hiv.BACKGROUND: patients with central serous chorioretinopathy (CSC) have sudden-onset, painless, uniocular blur that is typically diagnosed via fundus and fluorescein angiographic appearance. The etiology and pathophysiology are not fully understood; however, there may be an association with an infectious etiology. This article presents two cases of hiv-positive patients in whom central serous chorioretinopathy developed and discusses the possible relationship between the two cases. The differential diagnosis, clinical features, angiographic appearance, management options, and proposed etiologies of CSC will be presented. case reports: A 34-year-old black man hiv reported to the eye clinic with decreased vision in his right eye. A diagnosis of central serous chorioretinopathy (CSC) was made on the basis of the clinical and fluorescein appearance. He is currently being monitored for resolution. A 44-year-old black man with profoundly compromised immunity also came to the eye clinic with CSC and hiv retinopathy. He later progressed to CMV retinitis and subsequently died. CONCLUSION: Although considered in many cases to be idiopathic, central serous chorioretinopathy has been associated with infectious etiologies, one of which could be hiv.- - - - - - - - - - ranking = 0.16666666666667keywords = retinitis (Clic here for more details about this article) |
3/68. HSV-1--induced acute retinal necrosis syndrome presenting with severe inflammatory orbitopathy, proptosis, and optic nerve involvement.OBJECTIVE: To present a unique case in which orbital inflammation, proptosis, and optic neuritis were the initial symptoms of acute retinal necrosis (ARN). The clinical presentation of ARN, as well as the currently recommended diagnostic procedures and guidelines for medical treatment of ARN, are summarized. DESIGN: Interventional case report. TESTING: polymerase chain reaction (PCR) techniques were made on the vitreous for cytomegalovirus, Epstein-Barr virus, herpes simplex virus (HSV), varicella zoster virus, and toxoplasmosis. A full laboratory evaluation was made together with HLA-typing and serologic tests measuring convalescent titers for HSV and other micro-organisms. magnetic resonance imaging scan, computed tomography (CT) scan, and fluorescein angiographic examination were performed. The patient was treated with acyclovir and oral prednisone. MAIN OUTCOME MEASURES: The patient was evaluated for initial and final visual acuity and for degree of proptosis, periocular edema, and vitreitis. RESULTS: The first symptoms and signs of ARN were eye pain, headache, proptosis, and a swollen optic nerve on CT scan. Other than increased c-reactive protein, all blood samples were normal. PCR was positive for HSV-type I in two separate vitreous biopsies. The patient had the strongly ARN-related specificity HLA-DQ7. CONCLUSIONS: This is the first report of HSV-induced ARN presenting with inflammatory orbitopathy and optic neuritis. polymerase chain reaction for HSV-1 was positive more than 4 weeks after debut of symptoms, which is a new finding. The combination of severe vitreitis and retinal whitening, with or without proptosis, should alert the clinician to the possibility of herpes infection and treatment with intravenous acyclovir started promptly.- - - - - - - - - - ranking = 0.082450142478694keywords = cytomegalovirus (Clic here for more details about this article) |
4/68. Monofocal outer retinitis associated with hand, foot, and mouth disease caused by coxsackievirus.PURPOSE: To report symptoms and signs from an otherwise healthy man with photopsia and monofocal outer retinitis occurring 3 days after the onset of hand, foot, and mouth disease. METHOD: Case report. RESULTS: Ophthalmic examination revealed a single circumscribed area of pigment epithelial mottling in the left eye and a corresponding nonarcuate absolute scotoma. fluorescein angiography demonstrated attenuation of the retinal pigment epithelium. serologic tests at 1 month after the onset disclosed serum antibody to enterovirus. CONCLUSION: The close association between the cutaneous eruption and the onset of visual symptoms suggests that the retinal lesion was caused by coxsackievirus infection.- - - - - - - - - - ranking = 0.83333333333333keywords = retinitis (Clic here for more details about this article) |
5/68. Progressive outer retinal necrosis caused by herpes simplex virus type 1 in a patient with acquired immunodeficiency syndrome.OBJECTIVE/BACKGROUND: To identify the etiologic agent of rapidly progressive outer retinal necrosis (PORN) in a 32-year-old man with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from cytomegalovirus (CMV). Multiple yellowish spots appeared in the deep retina without evidence of intraocular inflammation or retinal vasculitis, diagnosed clinically as PORN. death occurred after failure of multiple organs. DESIGN: Case report. methods: Both globes were taken at autopsy, fixed in formalin, and examined histopathologically and immunohistochemically to identify causative agents in the retinal lesions. MAIN OUTCOME MEASURE: immunohistochemistry. RESULTS: All layers of the retina were severely damaged and contained focal calcification. Cytomegalic inclusion bodies were found in cells in the damaged retina of the right eye. Immunohistochemical studies for herpesviruses revealed the presence of CMV antigens in the right retina at the posterior pole and herpes simplex virus type 1 (HSV-1)-specific antigen in the periphery of both retinas. No varicella-zoster virus (VZV) antigen was detected in either retina. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, HSV-1 can be an etiologic agent.- - - - - - - - - - ranking = 0.24911680914536keywords = retinitis, cytomegalovirus (Clic here for more details about this article) |
6/68. herpes simplex virus dna identification from aqueous fluid in Fuchs heterochromic iridocyclitis.PURPOSE: To report the presence of herpes simplex virus dna in the aqueous humor of an eye with Fuchs heterochromic iridocyclitis. methods: In an eye with a clinical diagnosis of Fuchs heterochromic iridocyclitis, samples of aqueous humor and anterior capsule of the lens were obtained during cataract surgery. polymerase chain reaction was performed on the samples to detect the presence of viral dna including herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Serologic analysis was also performed for antiviral immunoglobulins. RESULTS: herpes simplex virus dna was identified in the aqueous humor but not in the anterior capsule. serum immunoglobulin g was positive for herpes simplex virus, varicella-zoster virus, and cytomegalovirus. CONCLUSIONS: The presence of herpes simplex virus dna in the aqueous humor of an eye with Fuchs heterochromic iridocyclitis suggests that herpes simplex virus infection may play a role in the pathogenesis of Fuchs heterochromic iridocyclitis.- - - - - - - - - - ranking = 0.16490028495739keywords = cytomegalovirus (Clic here for more details about this article) |
7/68. Intravitreal antiviral injections as adjunctive therapy in the management of immunocompetent patients with necrotizing herpetic retinopathy.PURPOSE: To report the use of intravitreal antiviral injections as adjunctive therapy in the management of three immunocompetent patients with necrotizing herpetic retinopathy. METHOD: Case series. RESULTS: Three patients with necrotizing herpetic retinopathy received intravitreal antiviral injections for treatment of progressive retinitis, despite standard intravenous acyclovir therapy. The retinitis resolved and visual acuity improved after a minimum of 6 months of follow-up in each case. CONCLUSION: Intravitreal antiviral injections may be a safe and efficacious adjunctive therapy in the management of patients with necrotizing herpetic retinopathy.- - - - - - - - - - ranking = 0.33333333333333keywords = retinitis (Clic here for more details about this article) |
8/68. lymphocytic choriomeningitis virus: an underdiagnosed cause of congenital chorioretinitis.PURPOSE: To elucidate the role and clinical spectrum of congenital lymphocytic choriomeningitis virus infection as a cause of chorioretinopathy, congenital hydrocephalus, and macrocephaly or microcephaly in the united states. methods: We performed complete ophthalmologic surveys of all residents at Misericordia, a home for the severely mentally retarded in chicago, and prospectively evaluated all patients with chorioretinitis or chorioretinal scars during a 36-month period at Children's Memorial Hospital, also located in chicago. Sera for patients demonstrating chorioretinal scars (a sign of intrauterine infection) were tested for toxoplasma gondii, rubella virus, cytomegalovirus, and herpes simplex virus and lymphocytic choriomeningitis virus antibodies. RESULTS: Four of 95 patients examined at the home had chorioretinal scars, and two of these patients had normal T. gondii, rubella virus, cytomegalovirus, and herpes simplex virus titers and dramatically elevated titers for lymphocytic choriomeningitis virus. Three of 14 cases of chorioretinitis at the hospital had normal T. gondii, rubella virus, cytomegalovirus, and herpes sim-plex virus titers and elevated lymphocytic choriomeningitis virus antibody titers. (A fourth case, diagnosed in 1996, was reported 2 years ago.) CONCLUSIONS: lymphocytic choriomeningitis virus was responsible for visual loss in two of four children secondary to chorioretinitis in a population of severely retarded children. The six new cases of lymphocytic choriomeningitis virus chorioretinitis identified in these two populations over the last 3 years, compared with the total number ever reported in the united states (10 cases), suggests that lymphocytic choriomeningitis virus may be a more common cause of congenital chorioretinitis than previously believed. Because its consequences for visual and psychomotor development are devastating, we conclude that the workup for congenital chorioretinitis should include lymphocytic choriomeningitis virus serology, especially if T. gondii, rubella virus, cytomegalovirus, and herpes simplex virus titers are negative.- - - - - - - - - - ranking = 1.9964672365814keywords = retinitis, cytomegalovirus (Clic here for more details about this article) |
9/68. lymphocytic choriomeningitis virus chorioretinitis mimicking ocular toxoplasmosis in two otherwise normal children.PURPOSE: To report unilateral macular lesions, mimicking toxoplasmic scars, in two children with serological evidence for lymphocytic choriomeningitis virus infection. methods: case reports. RESULTS: patients were 4 and 5 years old, with negative toxoplasma serologies and no sign of rubella, cytomegalovirus, or herpes simplex infection (TORCH evaluation). lymphocytic choriomeningitis virus infection was detected in both cases by enzyme-linked immunosorbent assay and confirmed by Western immunoblotting. The modes of infection were unknown; no history of symptomatic systemic lymphocytic choriomeningitis virus infection was reported, and lymphocytic choriomeningitis virus serologies were negative in the mothers of the patients. Neurological examinations and brain magnetic resonance imaging were normal. CONCLUSION: Our observations suggest that chorioretinal scars can be an isolated manifestation of lymphocytic choriomeningitis virus infection.- - - - - - - - - - ranking = 0.74911680914536keywords = retinitis, cytomegalovirus (Clic here for more details about this article) |
10/68. herpes simplex virus dna in the lens one year after an episode of retinitis.The present report describes a case where HSV was detected by polymerase chain reaction (PCR) in the lens cortical material removed during cataract surgery one year after resolution of retinal inflammation in a patient with ARN.- - - - - - - - - - ranking = 0.66666666666667keywords = retinitis (Clic here for more details about this article) |
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