J Korean Ophthalmol Soc > Volume 60(7); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(7):706-711.
DOI: https://doi.org/10.3341/jkos.2019.60.7.706    Published online July 15, 2019.
Frosted Branch Angiitis Associated with Epstein-Barr Virus Infection.
Hyeon Woo Son, Ji Eun Lee
Department of Ophthalmology, Maryknoll Hospital, Busan, Korea. ddalkieco@gmail.com
엡스타인-바 바이러스 감염에 의한 언가지혈관염
손현우⋅이지은
메리놀병원 안과
Correspondence:  Ji Eun Lee,
Email: ddalkieco@gmail.com
Received: 25 October 2018   • Revised: 12 December 2018   • Accepted: 19 June 2019
Abstract
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.
Key Words: Epstein-Barr virus;Optical coherence tomography;Retinal vasculitis


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