Diagnosis and treatment of optic neuritis as a manifestation of persistent herpesvirus infection: a clinical case
https://doi.org/10.21516/2072-0076-2024-17-2-93-98
Abstract
A clinical case of bilateral descending optic neuritis in a 63-year-old patient is presented. The patient, whose age is beyond the normal limit for this pathology, was previously treated for neuritis of the right eye, which had no effect and led to a complete atrophy of the optic nerve (ON). A timely correct diagnostics of the left eye, which revealed structural disorders of the optic nerve accompanied by inflammatory viral changes of brain tissue, was a key factor in choosing an adequate treatment, which helped retain visual functions. The clinical observation illustrates the polyetiological nature of inflammation of the ON, the viral agent playing a leading role. Importantly, ophthalmic manifestations of the herpesvirus infection may remain the only sign of this pathology for a long time, so the ophthalmologist must always be on the alert regarding the viral genesis of the disease.
About the Authors
J. Y. Issakhanova
NAO “Kazakh National Medical University named after S. Asfendiyarov. S. Asfendiyarov”
Kazakhstan
Kazakhstan
Jamilya Y. Issakhanova — Cand. of Med. Sci., assistant professor, chair of ophthalmology
94 Tole Bi St., Almaty 050000
A. K. Duisenova
NAO “Kazakh National Medical University named after S. Asfendiyarov. S. Asfendiyarov”
Kazakhstan
Kazakhstan
Amangul K. Duisenova — Dr. of Med. Sci., professor, head of chair of infectious and tropical diseases
94 Tole Bi St., Almaty 050000
A. Zh. Kurmasheva
O.M. Filatov Municipal Clinical Hospital No.15
Russian Federation
Russian Federation
Aziza Zh. Kurmasheva — ophthalmologist of the ophthalmology department
23 Veshnyakovskaya St., Moscow, 111539
D. E. Zhumabek
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Dauren E. Zhumabek — 6th year student
47 Piskaryovsky Ave., St. Petersburg, 195067
References
1. Sheremet N.L., Ronzina I.A., Galoyan N.S., Kazaryan E.E. Up to date methods of optic nerve evaluation in patients with optic neuropathy of various etiology. Vestnik oftal’mologii. 2011; 127 (2): 15–8 (In Russ.).
2. Povaljaeva D.A., Danilova L.P., Emanova L.P. Clinical and immunological monitoring of the etiological structure of idiopathic optic neuritis. Pacific Medical Journal. 2018; 2 (72): 74–7 (In Russ.). doi: 10.17238/PmJ1609-1175.2018.2.74-77
3. Bennett JL. Optic Neuritis. Continuum (Minneap Minn). 2019; 25 (5): 1236–64. doi: 10.1212/CON.0000000000000768
4. Zhang F, Sumida A, Margoleski J, et al. YSV-2 encephalitis presenting as multifocal ischemic stroke. Neurol Sci. 2017; 38 (12): 2229–30. doi 10.1007/s10072-017-3100-9
5. Kobayashi T, Sekar P, Meier J, et al. Acute retinal necrosis in a patient with remote severe herpes simplex encephalitis. BMJ Case Rep. 2019; 12 (5):e229137. doi: 10.1136/bcr-2018-229137
6. Andzhelov V.O., Krichevskaja G.I. Laboratory diagnosis of ophthalmological infections. Russian journal of ophthalmology. 2001; 1: 5–9 (In Russ.).
7. Eggenberger ER. Infectious optic neuropathies. Continuum (Minneap Minn). 2019; 25 (5): 1422–37. doi: 10.1212/CON.0000000000000777
8. Kimberlin DW, Lin CY, Sanchez PJ, et al. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial. J Pediatr. 2003 Jul; 143 (1): 16–25. doi: 10.1016/s0022-3476(03)00192-6
9. Getija E.G., Pankrat'eva L.L., Soldatova I.G., et al. Effect of recombinant human interferon-a2b (VIFERON®) on the interferon status of premature infants with complicated course of the neonatal period. Issues of practical paediatrics. 2010; 5 (Suppl 1): 14–6 (In Russ.).
10. Eshmolov S.N., Klimovitskaya E.G., Kuzmina M.N., Sitnikov I.G. Lesions of the nervous system in herpesvirus infections. Detskie infektsii. 2022; 21 (4): 15–20 (In Russ.). doi.org/10.22627/2072-8107-2022-21-4-15-20
11. Katz J, Yue S, Xue W. Herpes simplex and herpes zoster viruses in COVID-19 patients. Ir J Med Sci. 2021; 11: 1–5. doi: 10.1007/s11845-021-02714-z.5
12. Sitnikova E.P. Congenital cytomegalovirus infection: approaches to therapy. Effective pharmacotherapy. 2017; 10: 24–6 (In Russ.). https://umedp.ru/upload/iblock/f8d/viferon.pdf
Review
For citations:
Issakhanova J.Y., Duisenova A.K., Kurmasheva A.Zh., Zhumabek D.E. Diagnosis and treatment of optic neuritis as a manifestation of persistent herpesvirus infection: a clinical case. Russian Ophthalmological Journal. 2024;17(2):93-98. (In Russ.) https://doi.org/10.21516/2072-0076-2024-17-2-93-98
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