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TWO CASES OF ACUTE RETINAL NECROSIS DUE TO VARICELLA ZOSTER DESPITE PRIOR SHINGLES VACCINATION

Weinlander, Eric J., BA; Wang, Angeline L., MD; Jaru-ampornpan, Pimkwan, MD; Altaweel, Michael M., MD; Nork, T. Michael, MD, MS

Retinal Cases and Brief Reports: July 2019 - Volume 13 - Issue 3 - p 241–243
doi: 10.1097/ICB.0000000000000567
Case Report
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Purpose: To review two cases of acute retinal necrosis in adults due to varicella zoster virus despite prior shingles vaccination.

Methods: Retrospective chart review.

Patients: A 62-year-old man and a 64-year-old man with unilateral acute retinal necrosis who had shingles vaccinations 16 and 7 months before their ocular symptoms.

Results: Polymerase chain reaction confirmation of varicella zoster virus in the anterior chambers of both patients. Both patients had good responses to oral antiviral therapy and topical and/or oral steroids.

Discussion: These two cases demonstrate that singles vaccination is not an absolute protection against varicella zoster virus–related acute retinal necrosis. However, such vaccination may reduce the severity of the acute retinal necrosis.

Acute retinal necrosis is a rare but potentially devastating ocular disorder that can occur in otherwise healthy individuals. The authors report 2 cases of acute retinal necrosis confirmed by polymerase chain reaction to be positive for varicella zoster virus despite having had live-attenuated varicella zoster virus vaccine 16 and 7 months earlier.

Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.

Reprint requests: T. Michael Nork, MD, MS, Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, K6/456, Madison, WI 53792; e-mail: tmnork@wisc.edu

Supported by Research to Prevent Blindness, National Institutes of Health (NIH) P30 EY016665, and McPherson Eye Research Institute's Retina Research Foundation Kathryn & Latimer Murfee Chair.

None of the authors has any conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.