Poor Visual Recovery Following Treatment of Panuveitis in a 62 Year-old Man with Biopsy-proven Sarcoidosis

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Identifier walsh_2011_s2_c2
Title Poor Visual Recovery Following Treatment of Panuveitis in a 62 Year-old Man with Biopsy-proven Sarcoidosis
Creator Gelfand, Jeffrey
Subject Sarcoidosis; Herpesviridae Infections; Meningitis; Panuveitis; Retinal Vasculitis; Retinal Necrosis Syndrome, Acute; Pupil Disorders; Optic Nerve Diseases
Presenting Symptom Blurred vision OS; Uveitis
History A 62-year old male with blurred vision OS, progressive gait instability, episodic falling and confusion. Previous history significant for LP that revealed meningitis and lung and hilar lymph node biopsies that demonstrated sarcoidosis.
Clinical VA: 20/200 OS declining to NLP; RAPD OS: IOP: 8 OS; Retinal vasculitis OD
Neuroimaging MRI
Pathology VZV infection associated with VZV meningitis.
Disease/Diagnosis 1) Progressive Outer Retinal Necrosis OU due to varicella zoster virus infection, with associated VZV meningitis. 2) Likely infectious optic neuropathy OS due to varicella zoster virus, masquerading initially as sarcoid optic neuropathy.
Treatment Surgery; Steroids; IV antiviral agents; Immunosuppressive agents
References 1. Nakamoto, BK, et. al. Progressive outer retinal necrosis presenting with isolated optic neuropathy. Neurology 63(12), 2423-5, 2004. 2. Benz, MS, et. al. Progressive outer retinal necrosis in immunocompetent patients treated initially for optic neuropathy with systemic corticosteroids. American Journal o f Ophthalmology 135(4), 551-3, 2003. 3. Franco-Paredes, C, et. al. Aseptic meningitis and optic neuritis preceding varicella-zoster progressive outer retinal necrosis in a patient with AIDS. AIDS 16(7), 1045-9, 2003. 4. Lewis, JM, et. al. Progressive outer retinal necrosis after bone marrow transplantation. American Journal o f Ophthalmology 122(6), 892-5, 1996. 5. Salama B, et. al. Optic neuropathy in refractory neurosarcoidosis treated with TNF-alpha antagonist. Canadian Journal o f Ophthalmology 41(6), 766-8, 2006.
Relation is Part of Case presented at the NANOS 2011 Walsh Session, February 5
Contributor Primary Gelfand, Jeffrey
Contributor Secondary Duncan, Jacque; Green, Ari
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2011-02-05
Type Text
Format application/pdf
Source 43rd Annual Frank Walsh Society Meeting
Rights Management Copyright 2011. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s6611361
Setname ehsl_novel_fbw
Date Created 2012-05-31
Date Modified 2021-05-06
ID 179017
Reference URL https://collections.lib.utah.edu/ark:/87278/s6611361
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