Choroidal hypoperfusion and diffuse retinal occlusive arteritis associated with varicella-zoster virus: A case report

Herpesviruses are responsible for severe and sight-threatening inflammation of the posterior segment of the eye. The incidence of herpetic posterior segment inflammation is unknown and probably underestimated. The most common herpetic posterior lesions are necrotizing retinopathies, such as acute retinal necrosis in immunocompetent patients and progressive outer retinal necrosis in immunodepressed ones. Non-necrotizing herpetic retinopathies have also been reported but remain rare. They include retinal vasculitis [1], [2], [3], [4], [5], either occlusive or non-occlusive and involving either the veins or the arteries [6], [7], birdshot-like retinochoroidopathies [2], and frosted branch angiitis [1]. The pathophysiology of the non-necrotizing retinopathies remains unknown and the lesions could be due to a combination of major deleterious autoimmune processes initiated by the viral infection [2]. Finally, in exceptional cases, herpesviruses-associated uveitis can involve the choroid, with [8], [9] or without retinopathy [10].

Here, we report a rare case of unilateral varicella-zoster virus (VZV) uveitis with choroidal and choriocapillaris hypoperfusion followed by occlusive retinal arteritis.

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