Patients with an acute zonal occult outer retinopathy-like illness rapidly improve with valacyclovir treatment

Abstract

Purpose: To describe 3 cases of an acute zonal occult outer retinopathy-like illness responsive to valacyclovir hydrochloride.

Design: Retrospective, interventional case series.

Methods: Three patients were treated with valacyclovir and monitored by clinical examination, Goldmann visual field testing, and electroretinography.

Results: Patients with an acute zonal occult outer retinopathy-like illness presented following progressive vision loss. This course was immediately reversed by treatment with oral valacyclovir, and visual acuity and visual field improved significantly at 1 week and 1 month. Patients remained stable without treatment during a follow-up period ranging from 1 to 3 years.

Conclusions: Some conditions with features of acute zonal occult outer retinopathy may be attributable to a subacute herpetic viral infection that is responsive to oral antiviral medication.