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Frosted Branch Angiitis Associated with Epstein-Barr Virus Infection
엡스타인-바 바이러스 감염에 의한 언가지혈관염
JKOS 2019 Jul;60(7):706-11
Published online July 15, 2019;
Copyright © 2019 The Korean Ophthalmological Society.
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Hyeon Woo Son, MD, Ji Eun Lee, MD

Department of Ophthalmology, Maryknoll Hospital, Busan, Korea
메리놀병원 안과
Received October 25, 2018; Revised December 12, 2018; Accepted June 19, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To report a case of frosted branch angiitis (FBA) associated with Epstein-Barr virus (EBV) infection in a child.
Case summary: A 7-year-old boy presented with bilateral blurred vision. On ophthalmic examination, his best-corrected visual acuity was 20/25 in the right eye and 20/32 in the left eye. The pupils were equal, round, and reactive to light without a relative afferent pupillary defect. He had normal color vision in both eyes. Slit-lamp examination revealed no abnormalities in the anterior parts of the eyes. Fundoscopic examination revealed prominent white sheathing retinal vasculitis predominantly on the veins in all quadrants, as well as macular edema and irregular foveal reflex in both eyes. Fluorescein angiography showed normal blood flow, but late diffuse staining and leakage of the affected vessels. Spectral domain optical coherence tomography (SD-OCT) showed thickening of the vessel walls, swelling due to hyperreflective material, and hyperreflective retinal depositions. Serological tests and the serum polymerase chain reaction for EBV were positive. A diagnosis of FBA associated with EBV was made. He was treated with systemic acyclovir and steroids. The response was rapid, with improvement in visual acuity to 20/20 in both eyes by day 3. After 7 weeks, all clinical signs resolved and SD-OCT examination showed normal vessel wall thickness and the absence of hyperreflective depositions.
Conclusions: EBV may present with FBA even in the absence of a systemic sign of primary EBV infection. Thus, EBV should be considered as the etiology of FBA.
Keywords : Epstein-Barr virus, Optical coherence tomography, Retinal vasculitis


November 2019, 60 (11)