Chronic Herpetic Retinitis: Clinical Features and Long-Term Outcomes

Ocul Immunol Inflamm. 2018;26(1):94-103. doi: 10.1080/09273948.2017.1327079. Epub 2017 Jun 19.

Abstract

Introduction: Chronic uveitis treated with immunosuppressive agents may have unfavorable outcomes due to delays in diagnosis. The aim of this study was to review initial data from clinical and ocular assessments and patient outcomes following specific treatments for atypical herpes virus ocular infections.

Methods: The records of four consecutive patients with recurrent uveitis for at least five years treated in our department between 2001 and 2016 were retrospectively reviewed. They had atrophic retinal lesions resulting in an unfavorable outcome with lesion progression and vision loss under immunosuppressive treatment. Varicella zoster virus (1 case) and herpes simplex virus type 2 (3 cases) were detected in ocular samples.

Results: Uveitis was granulomatous and bilateral (3 cases) or unilateral (1 case). Immunosuppressive treatments worsened the clinical situation whereas antiherpetic treatments improved the control of intraocular inflammation.

Conclusion: This description should be added to the broad repertoire of clinical polymorphisms associated with herpes virus infections. Recognizing these cases should be useful due to their sensitivity to antiherpetic treatments.

Keywords: Herpes virus; macular edema; retinitis; uveitis; vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Viral / blood
  • Antiviral Agents / therapeutic use
  • Aqueous Humor / virology
  • Chronic Disease
  • DNA, Viral / genetics
  • Eye Infections, Viral / diagnosis*
  • Eye Infections, Viral / drug therapy
  • Eye Infections, Viral / virology
  • Female
  • Follow-Up Studies
  • Herpes Simplex / diagnosis*
  • Herpes Simplex / drug therapy
  • Herpes Simplex / virology
  • Herpes Zoster Ophthalmicus / diagnosis*
  • Herpes Zoster Ophthalmicus / drug therapy
  • Herpes Zoster Ophthalmicus / virology
  • Herpesvirus 2, Human / genetics
  • Herpesvirus 2, Human / immunology
  • Herpesvirus 2, Human / isolation & purification*
  • Herpesvirus 3, Human / genetics
  • Herpesvirus 3, Human / immunology
  • Herpesvirus 3, Human / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Retinitis / diagnosis*
  • Retinitis / drug therapy
  • Retinitis / virology
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antibodies, Viral
  • Antiviral Agents
  • DNA, Viral