Clinical Report: Uveitis and Retinal Vasculitis Associated with VZV

Overview

This report details a case of uveitis and retinal vasculitis caused by varicella-zoster virus (VZV) in a 74-year-old male. Early diagnosis and timely vitrectomy preserved the patient's vision, highlighting the importance of prompt intervention in VZV-related ocular complications.

Background

Varicella-Zoster Virus (VZV) can lead to significant ocular complications, particularly in cases of herpes zoster ophthalmicus (HZO). The rising incidence of HZO and its associated complications, such as uveitis, necessitates awareness and timely management to prevent vision loss. This case underscores the critical role of early diagnosis and intervention in managing VZV-related ocular diseases.

Data Highlights

Key Findings

• The patient was diagnosed with VZV-induced uveitis after metagenomic testing of vitreous fluid.
• Timely vitrectomy was performed, which successfully preserved the patient's vision.
• Significant elevations in cytokines (IL-6, IL-8, IL-10) were observed in the vitreous fluid.
• VZV can cause severe ocular complications, with a high incidence of uveitis in HZO patients.
• Early intervention is crucial to prevent blindness in patients with VZV-related ocular conditions.

Clinical Implications

Healthcare professionals should maintain a high index of suspicion for VZV-related ocular complications in patients presenting with visual disturbances, especially in the context of herpes zoster. Prompt diagnosis and intervention, including vitrectomy when indicated, can significantly improve patient outcomes.

Conclusion

This case highlights the importance of early recognition and management of VZV-induced uveitis to preserve vision. Continued education on the implications of VZV in ocular health is essential for timely intervention.

References

1. Hossain HA, O'Keefe GD, Retinal Physician, 2022 -- Diagnosis and Management of Retinal Vasculitis
2. Hinkle DM, Foster CS, Retinal Physician, 2008 -- Autoimmune Inflammatory Vitreoretinal Disease: Pathogenesis, Progression, and Treatment
3. NIH, Varicella-Zoster Virus Disease: Adult and Adolescent OIs
4. JAMA Network, Low-Dose Valacyclovir in Herpes Zoster Ophthalmicus: The Zoster Eye Disease Randomized Clinical Trial
5. Ocular Immunology and Inflammation, Role of Prophylactic Vitrectomy in Acute Retinal Necrosis
6. Retinal Physician — Diagnosis and Management of Retinal Vasculitis
7. Retinal Physician — Pars Plana Vitrectomy in Uveitis Management
8. Current U.S. OI Guidelines
9. Low-Dose Valacyclovir in Herpes Zoster Ophthalmicus: The Zoster Eye Disease Randomized Clinical Trial | Trials | JAMA Ophthalmology | JAMA Network
10. Role of Prophylactic Vitrectomy in Acute Retinal Necrosis in Preventing Rhegmatogenous Retinal Detachment: Systematic Review and Meta-analysis: Ocular Immunology and Inflammation: Vol 30 , No 2 - Get Access