Sterile iris abscess associated with herpes zoster ophthalmicus.
Herpes Zoster ophthalmicus
Iris nodule
Sterile abscess
Journal
American journal of ophthalmology case reports
ISSN: 2451-9936
Titre abrégé: Am J Ophthalmol Case Rep
Pays: United States
ID NLM: 101679941
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
22
09
2019
revised:
28
02
2021
accepted:
14
06
2021
entrez:
1
7
2021
pubmed:
2
7
2021
medline:
2
7
2021
Statut:
epublish
Résumé
To report a case of a sterile iris abscess associated with herpes zoster ophthalmicus (HZO). A 69-year-old African American female presented to SUNY Downstate Medical Center complaining of left-sided eye pain for two weeks. The patient had a best-corrected visual acuity of 20/30 OD and 20/200 OS. On external exam, vesicles were noted on the left upper lid and tip of the nose. Anterior segment exam was notable for decreased sensation without epithelial defects. The patient had 2+ stromal edema with 3+ cell and flare. The iris was flat with 1+ nuclear sclerosis OU. The intraocular pressure (IOP) was 14 mmHg OD and 40 mmHg OS. The patient was diagnosed with HZO with secondary uveitic glaucoma.At ten weeks, anterior segment inflammation resolved and IOP stabilized. However, an iris nodule was noted superior nasal which continued to enlarge by 16 weeks follow up. Iris ultrasound revealed a 3 × 3 mm elevated lesion with internal homogeneity suggestive of an abscess.At five months, a dense, mature cataract developed. The patient underwent cataract extraction with sector iridectomy. Gram staining and cultures were negative for organisms but positive for polymorphic neutrophils. Histopathology revealed fibrosis, surface necrosis, and stromal infiltration with chronic inflammatory cells consistent with chronic iritis and a sterile abscess secondary to HZO. HZO is associated with a range of ocular sequelae with acquired iris nodule only mentioned once in the literature. As the second documented case, our findings will add to the general fund of knowledge regarding iris lesions and HZO.
Identifiants
pubmed: 34195477
doi: 10.1016/j.ajoc.2021.101144
pii: S2451-9936(21)00153-5
pmc: PMC8239523
doi:
Types de publication
Case Reports
Langues
eng
Pagination
101144Informations de copyright
© 2021 The Authors. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
The following authors have no financial disclosures: SAL, LP, NA, MB, EM, HG, ME.
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