Multiple recurrent branch retinal artery occlusions associated with varicella zoster virus

Rene L. Zamora, Lucian V. Del Priore, Gregory A. Storch, Lawrence D. Gelb, James Sharp

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Purpose: The authors describe an immunocompetent patient who developed multiple recurrent branch retinal artery occlusions (BRAOs) associated with the varicella zoster virus (VZV). Methods: A 69-year-old woman with mild bilateral vitritis developed superior and inferior BRAOs in her right eye with decreased visual acuity to 20/40, and a peripheral BRAO inferotemporally in her left eye, One month later, the inferotemporal BRAO progressed proximally in her left eye with a decrease in visual acuity to 20/40. After an extensive negative systemic evaluation, she underwent a diagnostic pars plana vitrectomy of her right eye. Results: Vitreous fluid was positive for VZV DNA by polymerase chain reaction (PCR). The patient was treated with intravenous acyclovir and systemic oral steroids. After remaining disease free for 3 months, the patient had two recurrences: 1) a mild vitritis and 2) development of a new superior temporal artery occlusion in the left eye. Both recurrences were treated with oral acyclovir and systemic steroids. The patient remained recurrence free for 12 months on a maintenance dose of oral acyclovir, and for 4 additional months without acyclovir. Conclusions: Varicella zoster virus can be associated with the syndrome of multiple recurrent BRAOs. The diagnosis of VZV-associated BRAO can be established by PCR of intraocular fluid.

Original languageEnglish
Pages (from-to)399-404
Number of pages6
JournalRetina
Volume16
Issue number5
DOIs
StatePublished - Nov 13 1996

Keywords

  • branch retinal artery occlusion
  • herpes zoster
  • varicella zoster virus

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