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Sterile iris abscess associated with herpes zoster ophthalmicus

PURPOSE: To report a case of a sterile iris abscess associated with herpes zoster ophthalmicus (HZO). OBSERVATIONS: A 69-year-old African American female presented to SUNY Downstate Medical Center complaining of left-sided eye pain for two weeks. The patient had a best-corrected visual acuity of 20/...

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Autores principales: LoBue, Stephen A., Palazzolo, Laura, Antonova, Nataliya, Bivona, Michael R., Smith, Edward, Edelstein, Marcus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8239523/
https://www.ncbi.nlm.nih.gov/pubmed/34195477
http://dx.doi.org/10.1016/j.ajoc.2021.101144
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author LoBue, Stephen A.
Palazzolo, Laura
Antonova, Nataliya
Bivona, Michael R.
Smith, Edward
Edelstein, Marcus
author_facet LoBue, Stephen A.
Palazzolo, Laura
Antonova, Nataliya
Bivona, Michael R.
Smith, Edward
Edelstein, Marcus
author_sort LoBue, Stephen A.
collection PubMed
description PURPOSE: To report a case of a sterile iris abscess associated with herpes zoster ophthalmicus (HZO). OBSERVATIONS: A 69-year-old African American female presented to SUNY Downstate Medical Center complaining of left-sided eye pain for two weeks. The patient had a best-corrected visual acuity of 20/30 OD and 20/200 OS. On external exam, vesicles were noted on the left upper lid and tip of the nose. Anterior segment exam was notable for decreased sensation without epithelial defects. The patient had 2+ stromal edema with 3+ cell and flare. The iris was flat with 1+ nuclear sclerosis OU. The intraocular pressure (IOP) was 14 mmHg OD and 40 mmHg OS. The patient was diagnosed with HZO with secondary uveitic glaucoma. At ten weeks, anterior segment inflammation resolved and IOP stabilized. However, an iris nodule was noted superior nasal which continued to enlarge by 16 weeks follow up. Iris ultrasound revealed a 3 × 3 mm elevated lesion with internal homogeneity suggestive of an abscess. At five months, a dense, mature cataract developed. The patient underwent cataract extraction with sector iridectomy. Gram staining and cultures were negative for organisms but positive for polymorphic neutrophils. Histopathology revealed fibrosis, surface necrosis, and stromal infiltration with chronic inflammatory cells consistent with chronic iritis and a sterile abscess secondary to HZO. CONCLUSIONS AND IMPORTANCE: HZO is associated with a range of ocular sequelae with acquired iris nodule only mentioned once in the literature. As the second documented case, our findings will add to the general fund of knowledge regarding iris lesions and HZO.
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spelling pubmed-82395232021-06-29 Sterile iris abscess associated with herpes zoster ophthalmicus LoBue, Stephen A. Palazzolo, Laura Antonova, Nataliya Bivona, Michael R. Smith, Edward Edelstein, Marcus Am J Ophthalmol Case Rep Case Report PURPOSE: To report a case of a sterile iris abscess associated with herpes zoster ophthalmicus (HZO). OBSERVATIONS: A 69-year-old African American female presented to SUNY Downstate Medical Center complaining of left-sided eye pain for two weeks. The patient had a best-corrected visual acuity of 20/30 OD and 20/200 OS. On external exam, vesicles were noted on the left upper lid and tip of the nose. Anterior segment exam was notable for decreased sensation without epithelial defects. The patient had 2+ stromal edema with 3+ cell and flare. The iris was flat with 1+ nuclear sclerosis OU. The intraocular pressure (IOP) was 14 mmHg OD and 40 mmHg OS. The patient was diagnosed with HZO with secondary uveitic glaucoma. At ten weeks, anterior segment inflammation resolved and IOP stabilized. However, an iris nodule was noted superior nasal which continued to enlarge by 16 weeks follow up. Iris ultrasound revealed a 3 × 3 mm elevated lesion with internal homogeneity suggestive of an abscess. At five months, a dense, mature cataract developed. The patient underwent cataract extraction with sector iridectomy. Gram staining and cultures were negative for organisms but positive for polymorphic neutrophils. Histopathology revealed fibrosis, surface necrosis, and stromal infiltration with chronic inflammatory cells consistent with chronic iritis and a sterile abscess secondary to HZO. CONCLUSIONS AND IMPORTANCE: HZO is associated with a range of ocular sequelae with acquired iris nodule only mentioned once in the literature. As the second documented case, our findings will add to the general fund of knowledge regarding iris lesions and HZO. Elsevier 2021-06-17 /pmc/articles/PMC8239523/ /pubmed/34195477 http://dx.doi.org/10.1016/j.ajoc.2021.101144 Text en © 2021 The Authors. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
LoBue, Stephen A.
Palazzolo, Laura
Antonova, Nataliya
Bivona, Michael R.
Smith, Edward
Edelstein, Marcus
Sterile iris abscess associated with herpes zoster ophthalmicus
title Sterile iris abscess associated with herpes zoster ophthalmicus
title_full Sterile iris abscess associated with herpes zoster ophthalmicus
title_fullStr Sterile iris abscess associated with herpes zoster ophthalmicus
title_full_unstemmed Sterile iris abscess associated with herpes zoster ophthalmicus
title_short Sterile iris abscess associated with herpes zoster ophthalmicus
title_sort sterile iris abscess associated with herpes zoster ophthalmicus
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8239523/
https://www.ncbi.nlm.nih.gov/pubmed/34195477
http://dx.doi.org/10.1016/j.ajoc.2021.101144
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