VZV multifocal vasculopathy with ischemic optic neuropathy, acute retinal necrosis and temporal artery infection in the absence of zoster rash

J Neurol Sci. 2013 Feb 15;325(1-2):180-2. doi: 10.1016/j.jns.2012.12.021. Epub 2013 Jan 11.


We describe a 54-year-old diabetic woman who developed ischemic optic neuropathy followed by acute retinal necrosis and multiple areas of focal venous beading. Vitreous fluid contained amplifiable VZV DNA but not HSV-1, CMV or toxoplasma DNA. The clinical presentation was remarkable for jaw claudication and intermittent scalp pain, prompting a temporal artery biopsy that was pathologically negative for giant cell arteritis, but notable for VZV antigen. The current case adds to the clinical spectrum of multifocal VZV vasculopathy. The development of acute VZV retinal necrosis after ischemic optic neuropathy supports the notion that vasculitis is an important additional mechanism in the development of VZV retinal injury.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Exanthema*
  • Female
  • Herpes Zoster / complications
  • Herpes Zoster / diagnosis*
  • Herpesvirus 3, Human*
  • Humans
  • Optic Neuropathy, Ischemic / complications
  • Optic Neuropathy, Ischemic / diagnosis*
  • Retinal Necrosis Syndrome, Acute / complications
  • Retinal Necrosis Syndrome, Acute / diet therapy*
  • Temporal Arteries / pathology
  • Temporal Arteries / virology*