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Retin Cases Brief Rep. 2018 Jul 25. doi: 10.1097/ICB.0000000000000761. [Epub ahead of print]

ACUTE RETINAL NECROSIS ASSOCIATED WITH HERPES ZOSTER VACCINATION.

Author information

1
Department of Ophthalmology, Sir Charles Gairdner Hospital, Hospital Ave, Western Australia, Australia.
2
Private Ophthalmology Practice, Karrinyup, Washington, Australia.
3
Lions Eye Institute, Perth, Washington, Australia.

Abstract

PURPOSE:

To report a case of Zostavax-associated acute retinal necrosis in a patient with chronic lymphocytic leukemia.

METHODS:

Case report.

PATIENTS:

A 76-year-old white man.

RESULTS:

Unilateral acute retinal necrosis with obliterative angiopathy developed in close proximity of a Zostavax vaccine. Treatment with valacyclovir hydrochloride (1 g orally three times a day) and intravitreal ganciclovir (4 mg/0.1 mL) was initiated on presentation. Because of continuous increase of the retinal necrosis, patient was switched to intravenous acyclovir (7.5 mg/kg body weight, adapted to reduced glomerular filtration rate) and given intravitreal foscarnet (2.4 mg/0.1 mL). Despite being on maximal antiviral therapy, the patient suffered a central retinal artery occlusion.

DISCUSSION:

Acute retinal necrosis is a severe complication and potentially blinding disease of herpes zoster, and can occur in association with herpes zoster immunization, in particular, in immune suppressed patients.

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