Posterior Scleritis with Choroidal Effusion Secondary to Herpes Zoster Ophthalmicus

Ocul Immunol Inflamm. 2018;26(2):184-186. doi: 10.1080/09273948.2017.1351572. Epub 2017 Oct 5.

Abstract

Purpose: To describe a case of posterior scleritis with serous choroidal detachment that occurred as an acute complication of herpes zoster ophthalmicus (HZO).

Methods: Retrospective case report.

Results: A 75-year-old female presented with 3 days of painful, decreased vision in her left eye 1 week after being diagnosed with HZO. She had unilateral crusted vesicular lesions in the V1 dermatomal distribution and corneal pseudodendrites. Funduscopic examination demonstrated a large choroidal detachment in her left eye. B-scan ultrasonography revealed unilaterally thickened sclera consistent with posterior scleritis. She was treated with oral prednisone and a 2-week course of intravenous acyclovir. Two weeks after the initiation of treatment, her vision had improved and she demonstrated complete resolution of her pseudodendrites, posterior scleritis, and choroidal detachment.

Conclusions: Prompt recognition and treatment of this unique combination of clinical manifestations of HZO resulted in significant improvement in vision and resolution of the scleritis and choroidal detachment.

Keywords: Choroidal effusion; herpes zoster; herpes zoster ophthalmicus; posterior scleritis.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Aged
  • Antiviral Agents / therapeutic use
  • Choroid Diseases / diagnostic imaging
  • Choroid Diseases / drug therapy
  • Choroid Diseases / etiology*
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / therapeutic use
  • Herpes Zoster Ophthalmicus / complications*
  • Herpes Zoster Ophthalmicus / diagnosis
  • Herpes Zoster Ophthalmicus / drug therapy
  • Humans
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Scleritis / diagnostic imaging
  • Scleritis / drug therapy
  • Scleritis / etiology*
  • Ultrasonography

Substances

  • Antiviral Agents
  • Glucocorticoids
  • Prednisone
  • Acyclovir