Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India.
Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India.
Ocul Immunol Inflamm. 2021 Nov 17;29(7-8):1324-1327. doi: 10.1080/09273948.2020.1741649. Epub 2020 Apr 7.
: To describe unusual fundus findings in typical varicella zoster (VZV) kerato-uveitis.: Observational, retrospective case study of five patients diagnosed with VZV kerato-uveitis.: Four out of five cases had a history of typical herpes zoster ophthalmicus skin rash over the forehead. All five patients had stromal keratitis, granulomatous keratic precipitates, and mild-moderate anterior chamber reaction, and two cases had typical VZV-iris atrophic changes. All cases demonstrated clear vitreous and multiple hypopigmented choroidal lesions (MHCL) with indistinct borders only in the affected eyes. Imaging studies failed to demonstrate evidence of active or resolved choroiditis. MHCL remained status quo in all including two cases who had recurrences of kerato-uveitis.: We describe previously unreported novel fundus finding, MHCL in typical VZV-kerato-uveitis cases. We presume MHCL are due to loss of melanin from choroidal melanocytes secondary to the VZV infection and propose a term "choroidal vitiligo" to describe these novel fundus findings.
描述典型带状疱疹(VZV)虹膜炎中的不常见眼底发现。
对五例诊断为 VZV 虹膜炎的患者进行观察性、回顾性病例研究。
五例中有四例有额部典型带状疱疹皮疹病史。所有五例均有基质性角膜炎、肉芽肿性角膜后沉着物和轻度中度前房反应,两例有典型 VZV 虹膜萎缩性改变。所有病例均表现出清晰的玻璃体和多个边界不清的色素减退脉络膜病变(MHCL),仅在受累眼中可见。影像学研究未能显示出活动性或已解决的脉络膜炎的证据。MHCL 在所有患者中保持不变,包括两例虹膜炎复发的患者。
我们描述了在典型 VZV-虹膜炎病例中以前未报道过的新型眼底发现,即 MHCL。我们推测 MHCL 是由于 VZV 感染导致脉络膜黑色素细胞中黑色素丢失所致,并提出“脉络膜白癜风”一词来描述这些新型眼底发现。