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Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis

PURPOSE: To describe an atypical case of necrotizing herpetic retinitis (NHR) that presented initially with mild anterior uveitis, optic disc swelling, and peripapillary serous retinal detachment (SRD). OBSERVATIONS: A 48-year-old Asian Indian man presented with blurred central vision and pain in hi...

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Autores principales: Ng, Caleb C., McDonald, H. Richard, Johnson, Robert N., Cunningham, Emmett T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850683/
https://www.ncbi.nlm.nih.gov/pubmed/35198831
http://dx.doi.org/10.1016/j.ajoc.2022.101423
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author Ng, Caleb C.
McDonald, H. Richard
Johnson, Robert N.
Cunningham, Emmett T.
author_facet Ng, Caleb C.
McDonald, H. Richard
Johnson, Robert N.
Cunningham, Emmett T.
author_sort Ng, Caleb C.
collection PubMed
description PURPOSE: To describe an atypical case of necrotizing herpetic retinitis (NHR) that presented initially with mild anterior uveitis, optic disc swelling, and peripapillary serous retinal detachment (SRD). OBSERVATIONS: A 48-year-old Asian Indian man presented with blurred central vision and pain in his left eye. Examination revealed mild anterior chamber inflammation, optic disc swelling, and a peripapillary SRD in the affected eye. Multimodal imaging, including widefield fluorescein angiography, showed optic disc leakage and confirmed the presence of a peripapillary SRD, but was otherwise unremarkable with no evidence of retinitis. The patient was diagnosed with presumed Vogt-Koyanagi-Harada disease and was treated with systemic corticosteroids. While there was objective visual improvement initially, the patient subsequently noted peripheral vision loss and was found to have peripheral necrotizing retinitis and occlusive retinal vasculitis in affected eye. Polymerase chain reaction-based testing of aqueous humor detected varicella zoster virus DNA, confirming the diagnosis of NHR. CONCLUSION AND IMPORTANCE: Optic disc edema and peripapillary SRD may precede the development of overt retinitis in some patients with NHR.
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spelling pubmed-88506832022-02-22 Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis Ng, Caleb C. McDonald, H. Richard Johnson, Robert N. Cunningham, Emmett T. Am J Ophthalmol Case Rep Case Report PURPOSE: To describe an atypical case of necrotizing herpetic retinitis (NHR) that presented initially with mild anterior uveitis, optic disc swelling, and peripapillary serous retinal detachment (SRD). OBSERVATIONS: A 48-year-old Asian Indian man presented with blurred central vision and pain in his left eye. Examination revealed mild anterior chamber inflammation, optic disc swelling, and a peripapillary SRD in the affected eye. Multimodal imaging, including widefield fluorescein angiography, showed optic disc leakage and confirmed the presence of a peripapillary SRD, but was otherwise unremarkable with no evidence of retinitis. The patient was diagnosed with presumed Vogt-Koyanagi-Harada disease and was treated with systemic corticosteroids. While there was objective visual improvement initially, the patient subsequently noted peripheral vision loss and was found to have peripheral necrotizing retinitis and occlusive retinal vasculitis in affected eye. Polymerase chain reaction-based testing of aqueous humor detected varicella zoster virus DNA, confirming the diagnosis of NHR. CONCLUSION AND IMPORTANCE: Optic disc edema and peripapillary SRD may precede the development of overt retinitis in some patients with NHR. Elsevier 2022-02-11 /pmc/articles/PMC8850683/ /pubmed/35198831 http://dx.doi.org/10.1016/j.ajoc.2022.101423 Text en © 2022 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
Ng, Caleb C.
McDonald, H. Richard
Johnson, Robert N.
Cunningham, Emmett T.
Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis
title Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis
title_full Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis
title_fullStr Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis
title_full_unstemmed Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis
title_short Optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis
title_sort optic disc edema with peripapillary serous retinal detachment as the presenting sign of necrotizing herpetic retinitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850683/
https://www.ncbi.nlm.nih.gov/pubmed/35198831
http://dx.doi.org/10.1016/j.ajoc.2022.101423
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