Varicella Zoster Virus Retinitis

A 59-year-old male with a past medical history of polymyositis on multiple immunosuppressants and a recent episode of shingles treated one month ago, presents to Bascom Palmer with decreased vision and pain in the right eye. Visual acuity was 20/150 in the affected eye and 20/25 in the left eye. The right eye exhibited an anterior chamber cell reaction and diffuse peripheral retinal whitening on dilated fundus exam. An anterior chamber tap was performed which yielded a positive PCR test for Varicella Zoster Virus DNA. Patient was initiated on oral treatment but ultimately worsened and required inpatient admission for intravenous ganciclovir and six intravitreal injections of foscarnet and ganciclovir over the span of three weeks. The patients vision improved to 20/50 following completion of treatment and no more active lesions were identified on dilated fundus exam. 

Presentation Date: 12/05/2019

Issue Date: 08/01/2020