Influenza Retinitis: Association with Influenza Encephalitis

Abstract

Purpose: To report an unusual case of retinitis caused by influenza virus. Case: A 30-year-old male claimed partial color blindness after recovery from influenza encephalitis. Visual acuity was 0.3 in the right eye and 0.03 in the left. An ophthalmoscopic fundus examination looked normal, but fluorescein angiography revealed granular hyperfluorescence with multiple dark circular lesions at the posterior pole of both eyes. Serological testing revealed an influenza A virus infection. With corticosteroid pulse therapy (3 days) followed by oral methyl prednisolone for 1 month, visual acuity gradually recovered. Over the following 2-year period, visual acuity has recovered to 1.2 in both eyes, but color sensation still remains impaired. Conclusions: Influenza encephalitis can cause visual loss due to retinitis at the posterior pole.

The hidden burden of influenza: A review of the extra‐pulmonary complications of influenza infection

“…Both the uveal effusion syndrome and the optic neuritis responded to treatment with corticosteroids. More severe ocular manifestations have been reported in association with influenza A(H1N1)pdm09 infection—two cases of acute retinitis and a case of bleeding follicular conjunctivitis . All three patients recovered their vision although one did have persistently impaired color perception.…”

“…More severe ocular manifestations have been reported in association with influenza A(H1N1) pdm09 infection-two cases of acute retinitis and a case of bleeding follicular conjunctivitis. [181][182][183] All three patients recovered their vision although one did have persistently impaired color perception. In the patient with bleeding follicular conjunctivitis, viral RNA was detected by RT-PCR in the affected eye and in one of the retinitis cases, the patient had vitreous antibodies to A(H1N1).…”

Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis

“…2. In total, 44 cases of IAE in adults were identified from 31 reports (Ak et al , 2012; Akins et al , 2010; Alakare et al , 2010; Bartynski et al , 2009; Bulakbasi et al , 2006; Chen et al , 2010; Cheng et al , 2011; Cunha et al , 2012; Fukami et al , 2005; Gadoth et al , 2010; Goenka et al , 2014; Gonzalez & Brust, 2009; Hakoda & Nakatani, 2000; Hawkins et al , 1987; Hjalmarsson et al , 2009; Iijima et al , 2002; Ishii et al , 2015; Ito et al , 2011; Jeganathan et al , 2013; Khosla et al , 2011; Kimura et al , 2008; Lee et al , 2010; Salonen et al , 1997; Santini et al , 2012; Simon et al , 2013; Steinberg et al , 1972; Steininger et al , 2003; Tsai et al , 2011; Wang et al , 2011, 2015; Yamashita et al , 2008). The cases are summarized in the supplementary material.…”

Ocular effects caused by viral infections and corresponding vaccines: An overview of varicella zoster virus, measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2

“…In addition, it is occasionally possible to observe generalized uveal involvement, known as uveal effusion syndrome, characterized by conjunctival congestion, tenderness, pain exacerbated by eye movement, choroidal, and subretinal exudation (94). In the majority of cases symptoms resolves completely over time (90,(92)(93)(94) even though, in exceptionally severe cases, they can become permanent: an example is reported by Breker et al (95), describing the case of a 13 years old girl affected by IAV H1N1, who developed encephalitis associated with severe permanent visual impairment, caused by a confluent ischemic retinopathy and infarction of the lateral geniculate body.…”