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Varicella-Zoster Virus–Associated Multifocal Chorioretinitis in 2 Boys

Christina Meenken, MD, PhD1; Aniki Rothova, MD, PhD1
[+] Author Affiliations
1Departments of Ophthalmology, VU Medical Centre, Amsterdam (Dr Meenken), and Erasmus Medical Centre, Rotterdam (Dr Rothova), the Netherlands
JAMA Ophthalmol. 2013;131(7):969-970. doi:10.1001/jamaophthalmol.2013.167.
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Varicella-zoster virus (VZV) may cause severe posterior eye segment inflammation and represents a major cause of the clinical syndrome called acute retinal necrosis (ARN).1 Acute retinal necrosis is a sight-threatening condition and even nowadays is associated with a poor visual outcome. Typically, in ARN the visual acuity rapidly deteriorates, and the retinal inflammation may progress within several days (usually with a typical circumferential progression) to a full-thickness necrosis affecting the entire retinal periphery. Retinal detachment may complicate the course of ARN.2 Further, VZV was reported to cause a variety of other posterior eye segment manifestations, including diverse necrotizing and nonnecrotizing retinal features as well as retinal vasculitis solely.2,3 The correct diagnosis of these atypical cases is challenging because VZV is usually not suspected to be a causative agent and intraocular fluid analysis is therefore often not assessed, especially not in children. We report on 2 boys with unilateral multifocal chorioretinitis that was proven to be of VZV origin by intraocular fluid analysis.

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Figure 1.
Case 1

Multifocal active and inactive chorioretinal lesions.

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Figure 2.
Case 2

Multiple sharply demarcated chorioretinal lesions.

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