Central retinal artery occlusion following herpes zoster oph-thalmicus and meningitis in a patient with AIDS
Meilin Guan
Hongwei Dong
Kuifang Du
Abstract：Purpose: To report an unusual case of central retinal artery occlusion (CRAO) following herpes zoster ophthalmicus, herpes zoster meningitis, and Grade 3 (very high risk) hypertension in a patient with acquired immunodeficiency syndrome (AIDS).
Case presentation: A 51-year-old man with AIDS presented with herpes zoster involving the ophthalmic division of the left trigeminal nerve. Clinical findings included severe ptosis, restricted extraocular movements, reduced corneal sensation, anterior uveitis, a dilated pupil with absent light reflex, optic disc hyperemia, and tortuous retinal veins. The patient was febrile and had markedly elevated blood pressure (191/105 mmHg). Cerebrospinal fluid analysis revealed elevated protein levels, pleocytosis, and positive detection of varicella-zoster virus. Two weeks after initiating treatment, the patient developed CRAO in the left eye, and 2 months later, he suffered an acute cerebral stroke.
Conclusion: This case highlights an uncommon etiology of CRAO and subsequent stroke in an immunocompromised patient. The sequential vascular events likely resulted from the combined effects of herpes zoster-associated vasculopathy and severe hypertension, suggesting a potential pathogenic link between viral infection and vascular occlusion.
Keywords：central retinal artery occlusionherpes zoster ophthalmicusmeningitishypertensionAIDS
Publication Date：2025-09-30
Online Publishing Date：2025-12-02(First online date of this platform, not the publication date of the document)
Pages：5( 60-64 )