TY - JOUR
T1 - ACUTE RETINAL NECROSIS ASSOCIATED WITH HERPES ZOSTER VACCINATION
AU - Menghini, Moreno
AU - Raja, Vignesh
AU - Raiter, Jeremy
AU - Balaratnasingam, Chandrakumar
AU - Constable, Ian J
PY - 2021/3/1
Y1 - 2021/3/1
N2 - PURPOSE: To report a case of Zostavax-associated acute retinal necrosis in a patient with chronic lymphocytic leukemia.METHODS: Case report.PATIENTS: A 76-year-old white man.RESULTS: Unilateral acute retinal necrosis with obliterative angiopathy developed in close proximity of a Zostavax vaccine. Treatment with valacyclovir hydrochloride (1 g orally three times a day) and intravitreal ganciclovir (4 mg/0.1 mL) was initiated on presentation. Because of continuous increase of the retinal necrosis, patient was switched to intravenous acyclovir (7.5 mg/kg body weight, adapted to reduced glomerular filtration rate) and given intravitreal foscarnet (2.4 mg/0.1 mL). Despite being on maximal antiviral therapy, the patient suffered a central retinal artery occlusion.DISCUSSION: Acute retinal necrosis is a severe complication and potentially blinding disease of herpes zoster, and can occur in association with herpes zoster immunization, in particular, in immune suppressed patients.
AB - PURPOSE: To report a case of Zostavax-associated acute retinal necrosis in a patient with chronic lymphocytic leukemia.METHODS: Case report.PATIENTS: A 76-year-old white man.RESULTS: Unilateral acute retinal necrosis with obliterative angiopathy developed in close proximity of a Zostavax vaccine. Treatment with valacyclovir hydrochloride (1 g orally three times a day) and intravitreal ganciclovir (4 mg/0.1 mL) was initiated on presentation. Because of continuous increase of the retinal necrosis, patient was switched to intravenous acyclovir (7.5 mg/kg body weight, adapted to reduced glomerular filtration rate) and given intravitreal foscarnet (2.4 mg/0.1 mL). Despite being on maximal antiviral therapy, the patient suffered a central retinal artery occlusion.DISCUSSION: Acute retinal necrosis is a severe complication and potentially blinding disease of herpes zoster, and can occur in association with herpes zoster immunization, in particular, in immune suppressed patients.
KW - Aged
KW - Antiviral Agents/therapeutic use
KW - Eye Infections, Viral/diagnosis
KW - Glucocorticoids/therapeutic use
KW - Herpes Zoster/prevention & control
KW - Herpes Zoster Ophthalmicus/diagnosis
KW - Herpes Zoster Vaccine/adverse effects
KW - Humans
KW - Leukemia, Lymphocytic, Chronic, B-Cell/complications
KW - Male
KW - Methylprednisolone/therapeutic use
KW - Retinal Necrosis Syndrome, Acute/diagnosis
KW - Vaccination/adverse effects
U2 - 10.1097/ICB.0000000000000761
DO - 10.1097/ICB.0000000000000761
M3 - Article
C2 - 30048403
SN - 1935-1089
VL - 15
SP - 166
EP - 168
JO - Retinal cases & brief reports
JF - Retinal cases & brief reports
IS - 2
ER -
