Immunologic factors may play a role in herpes simplex virus 1 reactivation in the brain and retina after influenza vaccination

AbstractHerpes simplex virus 1 (HSV-1) is a nearly ubiquitous human pathogen, remaining dormant in its human host the majority of the time. The interaction between HSV-1 and the immune system represents a complicated balance of power that allows the virus to persist in the host for a lifetime. However, disruptions in the immune system can activate the virus with the potential to cause devastating infections in the central nervous system (CNS). We present a patient who suffered three consecutive yearly HSV-1 CNS episodes (encephalitis, seizure, and retinitis), each within days of his influenza vaccination. We highlight subtle immunologic defects in this patient that may have allowed unchecked viral replication and resultant disease manifestations, as well as the potential role of influenza vaccine in tipping this balance in favor of HSV-1

Central Retinal Artery Occlusion With Subsequent Central Retinal Vein Occlusion in Biopsy-Proven Giant Cell Arteritis

Central retinal artery occlusion with subsequent central retinal vein occlusion in the same eye is a rare entity. We present a 72-year-old man with biopsy-proven giant cell arteritis who developed bilateral arteritic anterior ischemic optic neuropathy and a left central retinal artery occlusion. Subsequently, he developed a left central retinal vein occlusion within 2 weeks of his initial vision loss. His vision did not improve with corticosteroids

An ultrastructural study of the pathology of the retinal pigment epithelium, Bruch\u27s membrane, and the choriocapillaris in the aged Fischer 344 rat.

PURPOSE: The neural retinal degeneration in the aging Fischer 344 (F344) rat has been previously characterized. Here we describe the ultrastructural changes that occur in the retinal pigment epithelium (RPE), Bruch\u27s membrane, and choriocapillaris in the periphery of the aged Fischer 344 rat. METHODS: F344 eyes from 24-month-old animals (n = 4 animals, 8 eyes) were fixed and embedded for ultrastructural study. Serial mid-sagittal sections were taken from the superior peripheral retinas within 300 microm of the ora serrata. Pathology within the RPE, Bruch\u27s membrane, and choriocapillaris was described. RESULTS: Progressive changes were seen in the RPE/Bruch\u27s/choriocapillaris complex, increasing anteriorly as the ora serrata was approached. Early pathology of the RPE included increased number of basal infoldings, increased number of phagolysosomes and lipofuscin deposits, attenuation, inclusion of vasculature, vesicle formation, and whirling extensions of the basement membrane into the cytoplasm. Bruch\u27s membrane showed spots of considerable thinning, but most prominent was the nodular thickening. The choriocapillaris was found to have severe endothelial degeneration and transformation to fibrous tissue in the most severely affected regions. Lipofuscin was also found in areas of degenerated choriocapillaris. CONCLUSIONS: Prior work focused on the neural retina, documented photoreceptor cell loss, and showed that Müller cell changes preceded that loss in the periphery of the F344 rat. It is now evident that the pathology in the RPE/Bruch\u27s membrane/choriocapillaris complex may also be a critical component of the overall degenerative process. A possible mechanism for the extensive peripheral retinal degeneration in the F344 is presented