| 본문 : Purpose : To report a case of bilateral ischemic retinal vasculitis 2 months after the onset of chickenpox
Case summary : A healthy 31-year-old woman presented with a 2-week history of appearance of floaters and a one-week history of blurred vision. She had a history of herpes simplex virus infection with cutaneous vesicular eruption and was treated with oral acyclovir 2 months ago. At presentation, best corrected visual acuity in both eyes was 20/32. Examination of the anterior segments was unremarkable and a few cells were present in the anterior vitreous. Fundus examination revealed a flat posterior pole with sheathing and vasculitis. Wide fluorescence angiography showed multiple vascular leakages. Serologic tests were positive for both IgM and IgG anti-VZV antibodies, which confirmed a recent primary VZV infection. The patient was treated with an antiviral agent combined with oral corticosteroid i.e. oral prednisolone 50mg for 1 week and tapering over 1 month in conjunction with acyclovir 400mg 5 times daily for 1 month. After 1 month, vascular leakage was decreased but photoreceptor disruption was observed on optical coherence tomography and a corresponding sectoral visual field defect was observed on Humphrey visual field test. The best corrected visual acuity improved to 20/20 after 2 months, which was maintained for 3 years. However, sectoral visual field defect corresponding to the photoreceptor disruption persisted until the final follow up.
Conclusions : Ocular involvement after primary infection with varicella zoster virus (VZV) is very rare, and usually occurs in children and young adolescents with acute retinal necrosis or optic neuritis. This case demonstrated atypical clinical features of retinal vasculitis as compared to acute retinal necrosis or optic neuritis.
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