Retinal cases & brief reports · 2026
EPSTEIN-BARR VIRUS-ASSOCIATED FROSTED BRANCH ANGIITIS: A CASE REPORT AND BRIEF REVIEW.
СтатьяКлинический случайОбзорНазвание и аннотация: Перевод в очереди
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Cao Angela A, Curran Christian D, Diaz Pedro Monsalve, Hause Emily, Koozekanani Dara, Johnson Max R, Armbrust Karen R
Аннотация
PURPOSE: The objective of this study was to report the clinical presentation, treatment course, and outcome of a case of bilateral frosted-branch angiitis and neuroretinitis associated with acute Epstein-Barr virus (EBV) infection in a pediatric patient with Turner syndrome.
METHODS: This was a case report with multimodal ocular imaging and extensive systemic workup.
RESULTS: A 16-year-old adolescent girl with Turner syndrome presented with acute bilateral vision loss, hearing loss, and ataxia. Ocular examination showed bilateral extensive perivascular sheathing, optic disk edema, and macular exudates. Fluorescein angiography showed focal retinal ischemia and late optic disk leakage in both eyes. Macular optical coherence tomography was remarkable for intraretinal and subretinal fluid with scattered hyperreflective foci in both eyes. Magnetic resonance imaging of the brain and orbits showed a supratentorial T2 signal without enhancement, consistent with inactive vasculopathy. Results of a broad systemic workup were notable only for elevated EBV viral capsid antigen IgM with undetectable EBV viral capsid antigen IgG. After treatment with IV methylprednisolone followed by oral prednisone, the patient's best-corrected visual acuity in both eyes improved from 20/200 to 20/20.
CONCLUSION: Ocular symptoms and imaging biomarkers in this case of EBV-associated frosted branch angiitis resolved after high-dose systemic corticosteroid monotherapy. Although treatment with antiviral medications is reported in other frosted branch angiitis cases associated with acute EBV infection, this case underscores the treatable nature of this disease without antivirals, the use of which is not supported by the broader literature for EBV infection or postviral inflammation.
METHODS: This was a case report with multimodal ocular imaging and extensive systemic workup.
RESULTS: A 16-year-old adolescent girl with Turner syndrome presented with acute bilateral vision loss, hearing loss, and ataxia. Ocular examination showed bilateral extensive perivascular sheathing, optic disk edema, and macular exudates. Fluorescein angiography showed focal retinal ischemia and late optic disk leakage in both eyes. Macular optical coherence tomography was remarkable for intraretinal and subretinal fluid with scattered hyperreflective foci in both eyes. Magnetic resonance imaging of the brain and orbits showed a supratentorial T2 signal without enhancement, consistent with inactive vasculopathy. Results of a broad systemic workup were notable only for elevated EBV viral capsid antigen IgM with undetectable EBV viral capsid antigen IgG. After treatment with IV methylprednisolone followed by oral prednisone, the patient's best-corrected visual acuity in both eyes improved from 20/200 to 20/20.
CONCLUSION: Ocular symptoms and imaging biomarkers in this case of EBV-associated frosted branch angiitis resolved after high-dose systemic corticosteroid monotherapy. Although treatment with antiviral medications is reported in other frosted branch angiitis cases associated with acute EBV infection, this case underscores the treatable nature of this disease without antivirals, the use of which is not supported by the broader literature for EBV infection or postviral inflammation.