Clinical course of von Szily reaction: Case report and comprehensive review of the literature
Purpose: To describe a rare case of von Szily reaction (VSR) accompanied by a comprehensive review of the literature. Observations: A 57-year-old woman with herpes zoster ophthalmicus (HZO) associated with ipsilateral sectoral scleritis and anterior uveitis (sclerouveitis) subsequently developed con...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993620302425 |
| _version_ | 1818844541964255232 |
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| author | Caleb C. Ng Judy J. Chen Anita Agarwal Emmett T. Cunningham, Jr. |
| author_facet | Caleb C. Ng Judy J. Chen Anita Agarwal Emmett T. Cunningham, Jr. |
| author_sort | Caleb C. Ng |
| collection | DOAJ |
| description | Purpose: To describe a rare case of von Szily reaction (VSR) accompanied by a comprehensive review of the literature. Observations: A 57-year-old woman with herpes zoster ophthalmicus (HZO) associated with ipsilateral sectoral scleritis and anterior uveitis (sclerouveitis) subsequently developed contralateral necrotizing retinitis, leading to a diagnosis of VSR. A literature review revealed 10 additional cases of VSR. The full VSR cohort of 11 subjects included six women and five men, had a median age of 39 years (range 21–78 years), and most presented with HZO (n = 7, 63.6%), often associated with either ipsilateral anterior uveitis (n = 5; 45.5%) or keratitis (n = 4; 36.4%). All 11 cases developed necrotizing retinitis in the fellow eye, at a median of six weeks following onset in the sentinel eye. The most frequently implicated agent was varicella zoster virus (VZV; n = 8, 72.7%). A high proportion of the eight patients with VZV-associated VSR were identified as having increased risk of VZV reactivation, including age of 50 years or greater (n = 5, 62.5%), an underlying malignancy (n = 3, 37.5%), and/or use of immunosuppressive medication (n = 2, 25.0%). Conclusion: This was the first reported case of VSR presenting as HZO-associated with sclerouveitis. A comprehensive literature review revealed that most previously reported cases presented with HZO associated with isolated anterior uveitis and/or keratitis, and that all reported cases of VSR developed necrotizing retinitis in the fellow eye, typically within two months of initial presentation. Patients with VZV-associated VSR often had known risk factors for VZV reactivation. |
| first_indexed | 2024-12-19T05:15:25Z |
| format | Article |
| id | doaj.art-db09b49acdea4452ba51c69709e03bfa |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-19T05:15:25Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-db09b49acdea4452ba51c69709e03bfa2022-12-21T20:34:40ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-12-0120100927Clinical course of von Szily reaction: Case report and comprehensive review of the literatureCaleb C. Ng0Judy J. Chen1Anita Agarwal2Emmett T. Cunningham, Jr.3West Coast Retina Medical Group, San Francisco, CA, USA; The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA; Corresponding author. West Coast Retina Medical Group 1445 Bush Street San Francisco, California, 94109, USA.West Coast Retina Medical Group, San Francisco, CA, USA; The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USAWest Coast Retina Medical Group, San Francisco, CA, USA; The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USAWest Coast Retina Medical Group, San Francisco, CA, USA; The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA; The Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA; The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USAPurpose: To describe a rare case of von Szily reaction (VSR) accompanied by a comprehensive review of the literature. Observations: A 57-year-old woman with herpes zoster ophthalmicus (HZO) associated with ipsilateral sectoral scleritis and anterior uveitis (sclerouveitis) subsequently developed contralateral necrotizing retinitis, leading to a diagnosis of VSR. A literature review revealed 10 additional cases of VSR. The full VSR cohort of 11 subjects included six women and five men, had a median age of 39 years (range 21–78 years), and most presented with HZO (n = 7, 63.6%), often associated with either ipsilateral anterior uveitis (n = 5; 45.5%) or keratitis (n = 4; 36.4%). All 11 cases developed necrotizing retinitis in the fellow eye, at a median of six weeks following onset in the sentinel eye. The most frequently implicated agent was varicella zoster virus (VZV; n = 8, 72.7%). A high proportion of the eight patients with VZV-associated VSR were identified as having increased risk of VZV reactivation, including age of 50 years or greater (n = 5, 62.5%), an underlying malignancy (n = 3, 37.5%), and/or use of immunosuppressive medication (n = 2, 25.0%). Conclusion: This was the first reported case of VSR presenting as HZO-associated with sclerouveitis. A comprehensive literature review revealed that most previously reported cases presented with HZO associated with isolated anterior uveitis and/or keratitis, and that all reported cases of VSR developed necrotizing retinitis in the fellow eye, typically within two months of initial presentation. Patients with VZV-associated VSR often had known risk factors for VZV reactivation.http://www.sciencedirect.com/science/article/pii/S2451993620302425Herpes simplex virusHerpes zoster ophthalmicusImmunocompromisedNecrotizing retinitisScleritisSclerouveitis |
| spellingShingle | Caleb C. Ng Judy J. Chen Anita Agarwal Emmett T. Cunningham, Jr. Clinical course of von Szily reaction: Case report and comprehensive review of the literature American Journal of Ophthalmology Case Reports Herpes simplex virus Herpes zoster ophthalmicus Immunocompromised Necrotizing retinitis Scleritis Sclerouveitis |
| title | Clinical course of von Szily reaction: Case report and comprehensive review of the literature |
| title_full | Clinical course of von Szily reaction: Case report and comprehensive review of the literature |
| title_fullStr | Clinical course of von Szily reaction: Case report and comprehensive review of the literature |
| title_full_unstemmed | Clinical course of von Szily reaction: Case report and comprehensive review of the literature |
| title_short | Clinical course of von Szily reaction: Case report and comprehensive review of the literature |
| title_sort | clinical course of von szily reaction case report and comprehensive review of the literature |
| topic | Herpes simplex virus Herpes zoster ophthalmicus Immunocompromised Necrotizing retinitis Scleritis Sclerouveitis |
| url | http://www.sciencedirect.com/science/article/pii/S2451993620302425 |
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