PurposeTo report the clinical course of two cases of acute retinal necrosis (ARN) caused by varicella zoster virus (VZV) and cytomegalovirus (CMV) co-infection detected by polymerase chain reaction (PCR) on aqueous tap.MethodsObservational case reports.ResultsTwo patients presented to our services with unilateral panuveitis suggestive of ARN complicated by hemorrhagic vasculitis and started empirical therapy. Aqueous PCR was performed on the same day and showed double positivity for VZV and CMV, which guided treatment. At follow-up, wide-field color fundus imaging and high-resolution optical coherence tomography showed resolution of active retinitis.ConclusionOur cases suggest that ARN complicated by hemorrhagic vasculitis may be secondary to CMV and VZV co-infection, both in patients with an unremarkable clinical history and in those with immunodeficiency. In our cases, aqueous PCR testing was of paramount importance to determine the aetiology of ARN and to adjust the antiviral therapy accordingly.

Acute Retinal Necrosis Caused by Varicella Zoster Virus and Cytomegalovirus Co-Infection / M.P. Dolci, C. Donà, C. Mapelli, M. Nassisi, F. Zicarelli, A. Invernizzi, A. Lombardi, G. Casalino, F. Viola. - In: OCULAR IMMUNOLOGY AND INFLAMMATION. - ISSN 0927-3948. - (2024), pp. 1-5. [Epub ahead of print] [10.1080/09273948.2024.2404092]

Acute Retinal Necrosis Caused by Varicella Zoster Virus and Cytomegalovirus Co-Infection

M.P. Dolci
Primo
;
M. Nassisi;A. Invernizzi;F. Viola
Ultimo
2024

Abstract

PurposeTo report the clinical course of two cases of acute retinal necrosis (ARN) caused by varicella zoster virus (VZV) and cytomegalovirus (CMV) co-infection detected by polymerase chain reaction (PCR) on aqueous tap.MethodsObservational case reports.ResultsTwo patients presented to our services with unilateral panuveitis suggestive of ARN complicated by hemorrhagic vasculitis and started empirical therapy. Aqueous PCR was performed on the same day and showed double positivity for VZV and CMV, which guided treatment. At follow-up, wide-field color fundus imaging and high-resolution optical coherence tomography showed resolution of active retinitis.ConclusionOur cases suggest that ARN complicated by hemorrhagic vasculitis may be secondary to CMV and VZV co-infection, both in patients with an unremarkable clinical history and in those with immunodeficiency. In our cases, aqueous PCR testing was of paramount importance to determine the aetiology of ARN and to adjust the antiviral therapy accordingly.
Acute retinal necrosis; co-infection; cytomegalovirus; polymerase chain reaction; varicella zoster virus
Settore MEDS-17/A - Malattie dell'apparato visivo
2024
25-set-2024
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1110009
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