Case Report

Frosted branch angiitis caused by Varicella Zoster virus in an immunocompetent patient


Introduction: Frosted branch angiitis(FBA) is a panuveitis with sheating of all retinal vesssels.
Case presentation: Herein we report an immunocompetent person who presented with fever, headache, atypical rash, and hazy vision. Ophthalmoscopy of both eyes revealed perivascular sheathing with frosted branch angiitis pattern in veins, patchy retinal hemorrhages. Aqueous PCR analysis turned positive for VZV.
Discussion: This case illustrates that VZV should be considered in the differential diagnosis of retinal perivasculitis. Since a rapid and accurate diagnosis is crucial for prompt administration of antiviral therapy, PCR-based analysis of aqueous humor is a valuable tool for detecting viruses.

Walker S, Iguchi A, Jones NP. Frosted branch angiitis:a review. Eye (Lond) 2004;18:527-533.

Kleiner RC. Frosted branch angiitis: clinical syndrome or clinical sign? Retina 1997;17:370-371.

Muthiah MN, Michaelides M, Child CS, Mitchell SM.Acute retinal necrosis: a national population-based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK. Br J Ophthalmol 2007;91:1452-1455.

Lau CH, Missotten T, Salzmann J, Lightman SL. Acute retinal necrosis features, management, and outcomes. Ophtalmology 2007; 114:756-762.

Barkmeier AJ, Feman SS. Frosted branch angiitis secondary to herpes simplex virus infection progressing to acute retinal necrosis. Retin Cases Brief Report 2009;3:36-37.

Shenoy R, Elagib EN, Al-Siyabi H. Frosted retinal branch angiitis in an immunocompetent adult due to herpes simplex virus. Indian J Ophthalmol 2001;49:56-7.

Ratra D, Jafferji S, Biswas J. Postsurgical bacterial endophthalmitis presenting as frosted branch angiitis: a case report. Retin Cases Brief Rep 2010;4:20-22.

Franco-Paredes C, Bellehemeur T, Merchant A, Sanghi P, DiazGranados C, Rimland D. Aseptic meningitis and optic neuritis preceding varicella- zoster progressive outer retinal necrosis in a patient with AIDS. AIDS 2002;16:1045-1049.

Gargiulo F, De Francesco MA, Nascimbeni G, Turano R, Perandin F, Gandolfo E, et al. Polymerase chain reaction as rapid diagnostic tool for therapy of acute retinal necrosis syndrome. J Med Virol 2003;69:397-400.

Tran TH, Rozenberg F, Cassoux N, Rao NA, LeHoang P, Bodaghi B. Polymerase chain reaction analysis of aqueous humour samples in necrotizing retinitis. Br J Ophthalmol 2003;87:79-83.

Nagel MA, Cohrs RJ, Mahalingam R, Wellish MC, Forghani B, Schiller A, et al. The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology 2008;70:853-860.

Narita K, Sato S. Systemic acyclovir was effective in a case of recurrent retinal angiitis. Rinsho Ganka(Jpn J Clin Ophthalmol)1990;44(5):739-43.

Ziyaeyan M, Alborzi A, Jamalidoust M, Moieni M, Pourabbas B. Seroepidemiology of varicella zoster virus infection among 1-70 years individuals in Iran. IRCMJ 2010;12:176-180.

IssueVol 7 No 2 (2015) QRcode
SectionCase Report(s)
Varicella zoster virus Frosted branch angiitis blurred vision

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Talebi-Taher M, Javadzadeh A, Hedayatfar A, Rahmani S, Ghanooni A, Mahmoodian R. Frosted branch angiitis caused by Varicella Zoster virus in an immunocompetent patient. Iran J Microbiol. 2015;7(2):118-122.