A Case of Herpes Zoster Chorioretinopathy Following Cataract Surgery
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Purpose
Multifocal chorioretinopathy can result from various causes, including the Herpes Zoster virus. This case highlights Herpes Zoster Chorioretinopathy following cataract surgery, emphasizing the need for thorough pre-operative assessment in uveitis patients.
Methods
A 71-year-old female underwent unilateral cataract surgery. Preoperatively, she experienced tingling on the same side of her forehead. Post-surgery, she developed forehead rashes and was diagnosed with shingles. Two months later, she presented with a red, photophobic eye and was diagnosed with anterior uveitis, treated with steroid eye drops. One month after the resolution, she developed hazy vision and was diagnosed with intermediate uveitis, multifocal chorioretinopathy, and cystoid macular oedema.
Results
Aqueous culture confirmed Herpes Zoster virus, linking her ocular inflammation to recent shingles. Treatment included intravitreal foscarnet and oral prednisolone, improving visual acuity from 6/36 to 6/9. She remains on valaciclovir and a maintenance dose of oral prednisolone.
Conclusion
To the best of our knowledge, this is the first reported case of Herpes Zoster chorioretinopathy following cataract surgery in the literature. Ocular inflammation due to Herpes viruses typically leads to unrelenting disease and necessitates prolonged use of immunosuppressants. Patients should undergo thorough assessment before surgery, and if deemed risky, surgery should be deferred as necessary.
Conflict of interest
No
1
Last name
YAP
Initials of first name(s)
C
Department
Ophthalmology
City
Norwich
Country
United Kingdom
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