J Korean Ophthalmol Soc.  2016 Jan;57(1):150-154. 10.3341/jkos.2016.57.1.150.

Multiple Serous Chorioretinopathy after Facial Herpes Zoster

• Hyun SY
• Kim DY
• Chae JB

• KMID: 2213862
• DOI: http://doi.org/10.3341/jkos.2016.57.1.150

Abstract

PURPOSE
To report a case of multiple serous chorioretinopathy after facial herpes zoster.
CASE SUMMARY
A 48-year-old male visited our clinic due to visual disturbance in the left eye which occurred 3 days after left facial pain and vesicles. Chemosis and multiple serous retinal detachments were found. The patient was diagnosed with multiple serous chorioretinopathy due to herpes zoster virus and was started on intravenous acyclovir at a dose of 10 mg/kg every 8 hours for 9 days and herpes eye ointment 5 times daily. After the initial treatment, oral prednisolone 60 mg was given daily for 6 days. Skin lesions were cleared, and abnormal fundus and visual acuity improved after treatment.
CONCLUSIONS
Ophthalmopathy including multiple serous chorioretinopathy should be considered in managing herpes zoster ophthalmicus patients.

Keyword

Chorioretinopathy; Herpes zoster ophthalmicus; Serous retinal detachment

MeSH Terms

Acyclovir
Facial Pain
Herpes Zoster Ophthalmicus
Herpes Zoster*
Herpesvirus 3, Human
Humans
Male
Middle Aged
Prednisolone
Retinal Detachment
Skin
Visual Acuity
Acyclovir
Prednisolone

Figure

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  Figure 1. Face photos showing facial herpes zoster. (A) Skin eruption corresponding to the dermatome of left ophthalmic branch of trigeminal nerve is observed. Nasal lesion shows Hutchinson's sign. (B) Oral mucosal erosion and pseudomembrane are observed at left upper soft plate.

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  Figure 2. Fundus photography, fluorescein angiography and optical coherence tomography showing multiple chorioretinopathy. (A) Multiple localized retinal detachments with subretinal fluid were found in macular and superior macular area. (B) Fluorescein an-giography shows multiple hyperfluorescent leaking points with localized serous detachment (arrowheads) between optic disc and macular area. (C) After treatment (two months later), fluorescein angiography shows no hyperfluorescence. (D) Multiple subretinal fluid and increased choroidal thickness were found. (E) After treatment, superior subretinal fluid moves downward to fovea. (F) After 1 month, subretinal fluid decreased. (G) After 2 months, subretinal fluid disappeared and there was no retinochoroidal inflammation.

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  Figure 3. Anatomy of Ophthalmic branch in trigeminal nerve. Long posterior ciliary nerve and short posterior ciliary nerve cover posterior scleral area in the orbit.

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