Atypical Auto-Immune Bilateral Optic Neuritis- Post Multiple Flavivirus Infections

Optic neuritis occurring post-infection may cause direct autoimmune attack to visual structures or indirect damage through occlusive vasculopathy ZIKV is a mosquito-transmitted flavivirus that is closely related to Dengue (DENV), and virological analysis revealed that ZIKV infects the cornea, vascularized choroid, the bipolar and ganglion layers of the retina, and the optic nerve. Although the mechanism by which ZIKV causes eye disease remains undefined. Neurotropic flaviviruses may first invade the brain,; then infect the optic tract, and later transit in a retrograde direction into the eye along the optic nerve. Alternatively, ocular infection may result from hematogenous spread of virus across the blood-retinal barrier. Additional studies are needed to define the precise mechanisms of ocular invasion by ZIKV. ZIKV infects both the eyes and testes in humans and in animal models, suggesting that immune privileged organs may support replication even weeks after resolution of viremia and clinical symptoms.