Varicella zoster-associated optic neuropathy with choroidal involvement

Abstract

A 62-year-old man had herpes zoster ophthalmicus involving the right V1 dermatome. His visual acuity was 0.6 in the right eye and the right optic disc appeared normal on his initial visit to us. His visual acuity decreased to 0.1 with optic disc edema and mild arterial infiltration in his right eye. Choroidal lesions were also confirmed by fluorescein angiography. The condition was considered varicella zoster-associated optic neuropathy with choroidal involvement. Intravenous administration of prednisolone (100 mg/day) was added to acyclovir sodium (750 mg/day) and tapered off over 2 months. His right visual acuity was 0.9 in one week. Optic disc swelling of his right eye and arterial infiltration gradually decreased, but consecutive optic disc and chorioretinal atrophy developed.