{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T11:14:53Z","timestamp":1698491693453},"reference-count":23,"publisher":"Akademiai Kiado Zrt.","issue":"48","license":[{"start":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T00:00:00Z","timestamp":1638057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2021,11,28]]},"abstract":"<jats:p><jats:bold>\u00d6sszefoglal\u00f3.<\/jats:bold> A varicella zoster v\u00edrus (VZV-) fert\u0151z\u00e9s t\u00edpusos els\u0151\n                    megjelen\u00e9se a b\u00e1r\u00e1nyhiml\u0151, k\u00e9s\u0151bb a reaktiv\u00e1ci\u00f3 sor\u00e1n a herpes zoster.\n                    Szem\u00e9szeti t\u00fcnet az V\/I-es agyideget \u00e9rint\u0151 zoster eset\u00e9n gyakori. A\n                    legrettegettebb szem\u00e9szeti manifeszt\u00e1ci\u00f3 az akut retinanekr\u00f3zis, mely fulmin\u00e1ns\n                    lefoly\u00e1s\u00fa, \u00e9s s\u00falyos sz\u00f6veti destrukci\u00f3t, valamint jelent\u0151s funkcion\u00e1lis\n                    k\u00e1rosod\u00e1st, gyakran vaks\u00e1got hagy maga ut\u00e1n. K\u00f6zponti idegrendszeri vascularis\n                    \u00e9rintetts\u00e9g el\u0151fordulhat b\u00e1r\u00e1nyhiml\u0151h\u00f6z t\u00e1rsul\u00f3an vagy a k\u00e9s\u0151bbi reaktiv\u00e1ci\u00f3k\n                    sor\u00e1n is, s\u00falyos k\u00f6vetkezm\u00e9nyekhez vezetve. A Semmelweis Egyetem Szem\u00e9szeti\n                    Klinik\u00e1j\u00e1n akut retinanekr\u00f3zis t\u00fcnet\u00e9vel \u00e9rkez\u0151 65 \u00e9ves f\u00e9rfi eset\u00e9t\n                    ismertetj\u00fck. Az Amerikai Szemorvost\u00e1rsas\u00e1g (AAO) diagnosztikus krit\u00e9riumainak\n                    mindenben megfelel\u0151 klinikai k\u00e9p alapj\u00e1n azonnal ind\u00edtott adekv\u00e1t d\u00f3zis\u00fa\n                    antivir\u00e1lis kezel\u00e9s mellett 3 nap m\u00falva, contralateralis hemiparesis h\u00e1tter\u00e9ben,\n                    a k\u00e9palkot\u00f3 vizsg\u00e1lat ipsilateralis ischaemi\u00e1s stroke-ot igazolt. Intraocularis\n                    mint\u00e1b\u00f3l PCR-vizsg\u00e1lat bizony\u00edtotta a v\u00edrus jelenl\u00e9t\u00e9t. Liquormint\u00e1ban enyhe\n                    anti-VZV-IgA-pozitivit\u00e1s mutatkozott. Az aktu\u00e1lis szem\u00e9szeti betegs\u00e9g \u00e9s a\n                    stroke t\u00e1rsul\u00e1s\u00e1nak h\u00e1tter\u00e9ben az \u00e9szlelt param\u00e9terek, valamint a relev\u00e1ns\n                    irodalmi adatok alapj\u00e1n a varicella zoster v\u00edrus okozta vasculopathi\u00e1t\n                    val\u00f3sz\u00edn\u0171s\u00edtett\u00fck. Gyermekkorban ez az ischaemi\u00e1s stroke leggyakoribb oka,\n                    feln\u0151ttkorban pedig az V\/I-es agyideg herpeses \u00e9rintetts\u00e9ge eset\u00e9n n\u00e9gy \u00e9s\n                    f\u00e9lszeres a kock\u00e1zat stroke kialakul\u00e1s\u00e1ra. A VZV-reaktiv\u00e1ci\u00f3 okozta akut\n                    retinanekr\u00f3zis \u00e9s a stroke t\u00e1rsul\u00e1s\u00e1nak lehet\u0151s\u00e9ge, b\u00e1r ismert a nemzetk\u00f6zi\n                    irodalomban, magyar szakirodalom tudom\u00e1sunk szerint eddig nem t\u00e1rgyalta, ez\n                    kiemeli eset\u00fcnk k\u00f6zl\u00e9s\u00e9nek jelent\u0151s\u00e9g\u00e9t. Orv Hetil. 2021; 162(48):\n                    1940\u20131945.<\/jats:p>\n                <jats:p><jats:bold>Summary.<\/jats:bold> The typical first onset of varicella zoster virus (VZV)\n                    infection is chickenpox, later herpes zoster during reactivation. Ophthalmic\n                    symptoms are common in herpes zoster affecting the V\/I cranial nerve. The most\n                    dreaded ophthalmic manifestation is acute retinal necrosis, which has a\n                    fulminant course and leaves severe tissue damage as well as significant\n                    functional impairment, often blindness. Vascular involvement in the central\n                    nervous system may occur in association with chickenpox or during subsequent\n                    reactivations leading to severe consequences. We report the case of a\n                    65-year-old male patient with symptoms of acute retinal necrosis at the\n                    Department of Ophthalmology, Semmelweis University. The clinical picture\n                    fulfilled the diagnostic criteria of the American Academy of Ophthalmology (AAO)\n                    and after 3 days of the immediately initiated adequate therapy, contralateral\n                    hemiparesis appeared, that was confirmed as an ipsilateral stroke by imaging\n                    study. The PCR analysis of an intraocular sample confirmed the presence of VZV.\n                    Mild anti-VZV IgA positivity was observed in the cerebrospinal fluid sample.\n                    Based on the current ophthalmic disease, the associated stroke alongside with\n                    the relevant literature data, varicella zoster vasculopathy was probable. VZV\n                    vasculopathy is the most common cause of ischemic stroke in childhood and in\n                    adulthood herpetic involvement of the V\/I cranial nerve elevates 4.5 times the\n                    risk of stroke formation. Though the possible association of acute retinal\n                    necrosis and stroke caused by VZV reactivation is known in the international\n                    literature, to the best of our knowledge it has not been discussed in Hungary so\n                    far, which highlights the importance of reporting our case. Orv Hetil. 2021;\n                    162(48): 1940\u20131945.<\/jats:p>","DOI":"10.1556\/650.2021.32260","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T13:24:50Z","timestamp":1639401890000},"page":"1940-1945","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["Akut retinanekr\u00f3zis \u00e9s ischaemi\u00e1s stroke t\u00e1rsul\u00e1sa"],"prefix":"10.1556","volume":"162","author":[{"given":"M\u00e1rton","family":"Magyar","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Szem\u00e9szeti Klinika, Budapest, M\u00e1ria u. 39., 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bence","family":"Gunda","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Neurol\u00f3giai Klinika, Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Rudas","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Orvosi K\u00e9palkot\u00f3 Klinika, Neuroradiol\u00f3giai Tansz\u00e9k, Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikl\u00f3s","family":"Resch","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Szem\u00e9szeti Klinika, Budapest, M\u00e1ria u. 39., 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n Zsolt","family":"Nagy","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Szem\u00e9szeti Klinika, Budapest, M\u00e1ria u. 39., 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judit","family":"Doh\u00e1n","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Szem\u00e9szeti Klinika, Budapest, M\u00e1ria u. 39., 1085"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1212\/WNL.0b013e31820a0d5d","article-title":"Zoster sine herpete: it would be rash to ignore it","volume":"76","author":"1 Kennedy","year":"2011","unstructured":"1 Kennedy PG. 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