Late ocular manifestations in neonatal herpes simplex infection

Abstract

Five patients who had had neonatal herpes simplex virus infection were re-examined at ages that varied from 6 to 9 years. In all of them the diagnosis had been supported by virus isolation and antibody titration, and herpes virus type 2, the genital strain, had been the causative agent. Only 1 of the patients was mentally retarded. Three of the patients had manifest squint, and only 1 patient had normal visual acuity in both eyes. The fundus changes varied from atrophy of the retinal pigment epithelium in 3 patients to atrophy of the optic disc in 2 eyes and extreme tortuosity of the retinal arterioles and veins in 1 patient. One patient developed bilateral retinitis with exudation into the vitreous at the age of 5 years. Fluorescein angiography of this patient showed peripheral vascular closure and preretinal neovascularisation, with leakage in both eyes. This may have been due to chronic retinal vasculitis; haemorrhagic infarction may have induced the damage to retinal tissues. Laser photocoagulation resulted in slight improvement of the visual acuity, clearing of the vitreous, and decrease of the fluorescein leakage.