Abstract:
Isolated herpes zoster optic neuritis is a rare sequelae of herpes zoster ophthalmicus (HZO). It can occur in the acute phase of HZO, or as post-herpetic complications. We report a case of a young patient with poorly controlled diabetes who developed herpes zoster optic neuritis one month after the initial skin manifestation despite completing a two-week course of oral acyclovir 800 mg five times a day. He complained of a five-day history of sudden onset, painless left eye blurring of vision. His vision over the left eye was no light perception with the presence of a left relative afferent pupillary defect. Fundus examination of the left eye revealed a swollen optic disc. Magnetic resonance imaging showed minimal fat streakiness over the left orbit. He was treated with one week of intravenous methylprednisolone 1 g/day, followed by a tapering dose of oral prednisolone (1 mg/kg/day) together with oral acyclovir 800 mg five times a day for another week. His visual acuity remained poor with a slight improvement in vision to hand motion.
摘要:
孤立性带状疱疹视神经炎是眼带状疱疹(HZO)的罕见后遗症。它可以发生在HZO的急性期,或疱疹后并发症。我们报告了一例控制不佳的年轻糖尿病患者,尽管每天五次完成为期两周的口服阿昔洛韦800mg疗程,但在最初的皮肤表现后一个月出现带状疱疹视神经炎。他抱怨有五天的突然发作史,无痛的左眼视力模糊.在存在左相对传入瞳孔缺损的情况下,他对左眼的视力没有光感知。左眼眼底检查显示视盘肿胀。磁共振成像显示左轨道上的脂肪条纹最小。他接受了1周静脉注射甲泼尼龙1克/天的治疗,然后逐渐减少口服泼尼松龙(1mg/kg/天)和口服阿昔洛韦800mg,每天5次,连续一周。他的视敏度仍然很差,视力和手部动作略有改善。