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Klin Monbl Augenheilkd 2019; 236(04): 590-593
DOI: 10.1055/a-0854-3476
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

Superficial and Deep Macular Vessel Occlusion in West Nile Virus

A New Insight to the Physiopathology of the Disease Thanks to OCT AngiographyOberflächliche und tiefe Makulagefäßokklusion im West-Nil-VirusEin neuer Einblick in die Pathophysiologie der Krankheit dank der OCT-Angiografie
Sophie Lopez Baumann
1   Ophtalmology, University of Lausanne, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
,
Daniele C. Rossi
1   Ophtalmology, University of Lausanne, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
,
Arthur Hammer
1   Ophtalmology, University of Lausanne, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
,
Jean-Philippe Chave
2   Infectiologie, Clinique de la Source, Lausanne, Switzerland
,
Yan Guex-Crosier
1   Ophtalmology, University of Lausanne, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
› Author Affiliations
Further Information

Publication History

received 10 October 2018

accepted 04 February 2019

Publication Date:
18 April 2019 (online)

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Introduction

West Nile virus is a single-stranded RNA flavivirus, endemic in Africa, the Middle East, and parts of Europe, South Asia, Australia, and North America, transmitted by infected mosquitoes (Culex species). Most human infections with West Nile virus remain asymptomatic, but 20% of patients present flu-like symptoms with fever, headache, malaise, back pain, myalgia, or anorexia [1]. Severe neuroinvasive disease can occur and is characterized by fever and meningitis, encephalitis, or even paralysis, including cranial nerve palsies.

Bilateral multifocal chorioretinitis is the most common ocular manifestation of West Nile virus. Other ocular manifestations include occlusive retinal vasculitis, retinal hemorrhages, vitritis, anterior uveitis, optic neuritis, and subconjunctival hemorrhage [2].

We describe here the optical coherence tomography angiography (OCT-A) findings in a case of West Nile virus-associated chorioretinitis. It is a new noninvasive imaging technique that enables the superficial and deep capillary plexus to be revealed, and thus areas of rarefaction or disruption of the capillary plexus, which can be correlated to vascular occlusion and ischemia, as seen in our patient. OCT-A can be a valuable complementary noninvasive tool in the assessment of macular involvement.

 

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