J Korean Ophthalmol Soc.  2008 May;49(5):853-857. 10.3341/jkos.2008.49.5.853.

Central Retinal Artery Occlusion Associated with Chickenpox

Affiliations
  • 1Department of Ophthalmology, College of Medicine, Chungnam National Univercity, Deajeon, Korea. kimjy@cnu.ac.kr

Abstract

PURPOSE: To report a case of central retinal artery occlusion (CRAO) associated with chickenpox.
CASE SUMMARY
A 24-year-old female presenting with a history of centripetal eruption and erythema, followed by vesicle and eschar, was diagnosed with varicella and managed in a local medical clinic. Five days after the varicella eruption, she experienced decreased vision in her left eye. On initial exam visual acuity was light-sense positive in the left eye and 1.0 in the right eye; on fundus examination the patient was diagnosed with CRAO. We performed hematologic tests including thrombophilia studies, but there were no abnormal findings on routine hematologic tests, the carotid artery, or cardiovascular examinations. Antinuclear antibody, rheumatoid factor, and antiphospholipid antibody were negative. Skin biopsy and PCR results both corresponded with varicella, and the patient was diagnosed with CRAO associated with chickenpox.

Keyword

Central retinal artery occlusion; Chickenpox

MeSH Terms

Antibodies, Antinuclear
Antibodies, Antiphospholipid
Biopsy
Carotid Arteries
Chickenpox
Erythema
Eye
Female
Hematologic Tests
Humans
Polymerase Chain Reaction
Retinal Artery
Retinal Artery Occlusion
Rheumatoid Factor
Skin
Thrombophilia
Vision, Ocular
Visual Acuity
Young Adult
Antibodies, Antinuclear
Antibodies, Antiphospholipid
Rheumatoid Factor

Figure

  • Figure 1. Fundus photograph show whitening of the superficial retina and cherry-red spot in the left eye.

  • Figure 2. Fluorescein angiograhs show delayed retinal arterial filling time and arteriovenous transit time in the left eye.

  • Figure 3. The result of VAV-PCR in patient serum. Lane S1 demonstrating specific 200 bp amplification of the VZV band. (Lane M = 200bp DNA ladder; Lane PC = positive control; Lane NC = negative control; Lane S1 = blood sample from patient; Bp = base pair)

  • Figure 4. Fundus photographs show disc pallor and arterial narrowing in the left eye at 18 months after the initial visit.


Cited by  1 articles

A Case of Multiple Complications in Herpes Zoster Ophthalmicus
Yeong Woo Son, Jin Hyun Kim, Seung Woo Lee
J Korean Ophthalmol Soc. 2015;56(5):789-793.    doi: 10.3341/jkos.2015.56.5.789.


Reference

References

1. Vyse AJ, Gay NJ, Hesketh LM, et al. Seroprevalence of antibody to varicella zoster virus in England and Wales in children and young adults. Epidemiol Infect. 2004; 132:1129–34.
Article
2. Macleod J. Davidson's priciples and practice of medicine. 19th ed.1. Edinburgh: Churchill Livingstone;1984. p. 730.
3. Duke-Elder S. System of ophthalmology. 3rd ed.15. London: Kimpton;1976. p. 167.
4. Hall S, Maupin T, Seward J, et al. Second varicella infections: Are they more common than previously thought? Pediatrics. 2002; 19:1068–73.
Article
5. Ostler HB, Thygeson P. The ocular manifestations of herpes zoster, varicella, infectious mononucleosis, and cytomegalovirus disease. Surv Ophthalmol. 1976; 21:148–59.
Article
6. Liesegang TJ. The varicella-zoster virus: systemic and ocular features. J Am Acad Dermatol. 1984; 11:165–91.
Article
7. Appel I, Frydman M, Savir H, et al. Uveitis and ophthalmoplegia complicating chickenpox. J Pediatr Ophthalmol. 1977; 14:346–8.
Article
8. Chu W, Pavan-Langston D. Ocular surface manifestations of the major viruses. Int Ophthalmol Clin. 1979; 19:135–67.
9. Edwards T. Ophthalmic complications of varicella. J Pediatr Ophthalmol. 1965; 2:37–40.
10. Jordan DR, Noel LP, Clarke WN. Ocular involvement in varicella. Clin Pediatr. 1984; 23:434–6.
Article
11. Matoba A. Ocular viral infections. Pediatr Infect Dis. 1984; 3:358–68.
12. Robb R. Cataracts acquired following varicella infection. Arch Ophthalmol. 1972; 87:352–4.
Article
13. Yoser SL, Forster DJ, Rao NA. Systemic viral infections and their retinal and choroidal manifestations. Surv Ophthalmol. 1993; 37:313–52.
Article
14. Garweg J, Bohnke M. Varicella zoster virus is strongly associated with atypical necrotizing herpetic retinopathies. Clin Infect Dis. 1997; 24:603–8.
15. Capone A Jr, Meredith TA. Central visual loss caused by chickenpox retinitis in a 2-year-old child. Am J Ophthalmol. 1992; 113:592–3.
Article
16. Purvin V, Hrisomalos N, Dunn D. Varicella optic neuritis. Neurology. 1988; 38:501–3.
17. Hugkulstone CE, Watt LL. Branch retinal arteriolar occlusion with chickenpox. Br J Ophthalmol. 1988; 72:78–80.
Article
18. Cho NC, Han HJ. Central retinal artery occlusion after varicella. Am J Ophthalmol. 1992; 114:235–6.
Article
19. Friedberg MA, Micale AJ. Monocular blindness from central retinal artery occlusion associated with chickenpox. Am J Ophthalmol. 1994; 117:117–8.
Article
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