A 35-year-old otherwise healthy man presented with a 1-week history of blurred vision in his RE. Medical history revealed mild chickenpox 3 weeks prior to his presentation, which resolved without complications. On ophthalmic examination, BCVA was 20/40 in the RE and 20/20 in the LE. There was no afferent pupillary defect. The intraocular pressure was 16 mmHg in both eyes. Minimal conjunctival hyperemia was present, and there were a few anterior chamber cells and 3+ vitreous cells and haze in the RE. Funduscopy revealed whitish retinal infiltration affecting the far periphery of the retina in one quadrant. Clinical examination results of the LE were normal.\nA diagnosis of ARN syndrome secondary to chickenpox infection was made, and the patient was treated with intravenous acyclovir (10 mg/kg, three times a day). Seven days later, there was no improvement in the RE, and the patient was given intravitreal ganciclovir (2 mg). After a 10-day course of intravenous acyclovir, the patient received valacyclovir (1000 mg, three times daily). Seven days after initiation of oral antiviral therapy, he received oral prednisone (0.5 mg/kg/day for 1 week, followed by gradual tapering over 8 weeks). Systemic corticosteroids were prescribed because of significant vitritis. BCVA of the RE improved to 20/20, with gradual resolution of vitreous inflammatory reaction. The peripheral retinal lesion healed with a residual chorioretinal scar. No fellow eye involvement or recurrence of ARN was observed after an 18-month period of follow-up.
A 42-year-old otherwise healthy man experienced redness and blurred vision in the LE 3 weeks after the onset of chickenpox. On examination, BCVA was 20/20 in the RE and 20/25 in the LE. His left pupil was small but reactive with no relative afferent pupillary defect. There were perilimbal injection, few fine keratic precipitates inferiorly, and 1+ anterior chamber cells in the LE. Intraocular pressure was 16 mmHg. There was no vitritis, and dilated fundus findings were normal. Examination results of the RE were normal. A diagnosis of unilateral acute non-granulomatous anterior uveitis secondary to varicella was made. The patient was treated by topical acyclovir five times a day, dexamethasone six times a day, and cycloplegic agent twice daily. The uveitis resolved within 2 weeks, and visual acuity improved to 20/20 in the LE. No recurrence of uveitis was observed over a follow-up period of 24 months.