Dr. Priyanka, P17413, Dr. Jyotirmay Biswas
A 68-year male diagnosed case of multiple myeloma presented with 6-week history of blurring of vision in both eyes. His BCVA was 3/60, N36 in right eye and 6/24, N24 in left eye. Examination revealed both eye quiet anterior chamber, vitreous cell 1+, vitreous haze 2+ with peripheral patch of active retinitis. PCR for intraocular fluid test was positive for Varicella Zoster Virus. The patient was treated with 1-week intravenous acyclovir with prednisolone 60mg/day, started on day 3. At day 7 fundus showed healing lesion with no vitreous traction so acyclovir changed to oral valacyclovir along with tapering dose of prednisolone.
Conclusions: ARN should also be considered in the differential for infectious uveitis in immunocompromised hosts, although it commonly occurs in immunocompetent individual. PCR from intraocular fluid plays important role in diagnosis of ARN.