Open AccessCytomegalovirus Infection with MRI Signal Abnormalities Affecting the Optic Nerves, Optic Chiasm, and Optic Tracts
Author(s) -
Suzann Pershing,
J. Lawrence Dunn,
Ahmir H. Khan,
Yaping Joyce Liao
Publication year - 2009
Publication title -
journal of neuro-ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.586
H-Index - 55
eISSN - 1536-5166
pISSN - 1070-8022
DOI - 10.1097/wno.0b013e3181b4a245
Subject(s) - optic chiasm , optic tract , cytomegalovirus , optic nerve , medicine , cerebrospinal fluid , optic chiasma , pathology , ophthalmology , herpesviridae , viral disease , virus , virology
A 49-year-old woman who had been immunosuppressed after a renal transplant developed bilateral severe visual loss. Visual acuities were finger counting and hand movements in the two eyes. Both optic nerves were pale. There were no other ophthalmic abnormalities. Brain MRI disclosed marked signal abnormalities involving the optic nerves, optic chiasm, and optic tracts. Cerebrospinal fluid polymerase chain reaction (PCR) was positive for cytomegalovirus. Treatment did not restore vision. Such extensive clinical and imaging involvement of the anterior visual pathway, which has been previously reported with other herpes viruses, illustrates the propensity for this family of viruses to track along axons.