Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1978 Jun;62(6):356–360. doi: 10.1136/bjo.62.6.356

Measles retinopathy during immunosuppression.

M Haltia, A Tarkkanen, A Vaheri, A Paetau, K Kaakinen, H Erkkilä
PMCID: PMC1043234  PMID: 352388

Abstract

A 14-year-old boy had an acute attack of measles while on cytotoxic chemotherapy for a testicular neoplasm. Two months later a fatal measles encephalopathy developed, verified by histological, ultrastructural, and immunofluorescent studies. Ophthalmoscopy showed progression of flat depigmented areas of the retina as well as prominent lesions mimicking central serous retinopathy or retinitis. Histopathological studies showed focal retinal necroses with invasion of pigment-laden macrophages into the retina. There were no inflammatory cell infiltrations in the choroid. The presence of structures with the morphological and antigenic properties of measles virus in the affected areas of the retina was shown by electron microsocpy and indirect immunofluorescence. With the increase of immunosuppressive therapy for various purposes the incidence of opportunistic measles virus infections is likely to rise. In the clinical management of such complications ophthalmological examination may prove very helpful.

Full text

PDF
356

Images in this article

357Image
on p.357
357Image
on p.357
358Image
on p.358
358Image
on p.358
359Image
on p.359

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Breitfeld V., Hashida Y., Sherman F. E., Odagiri K., Yunis E. J. Fatal measles infection in children with leukemia. Lab Invest. 1973 Mar;28(3):279–291. [PubMed] [Google Scholar]
  2. Drysdale H. C., Jones L. F., Oppenheimer D. R., Tomlinson A. H. Measles inclusion-body encephalitis in a child with treated acute lymphoblastic leukaemia. J Clin Pathol. 1976 Oct;29(10):865–872. doi: 10.1136/jcp.29.10.865. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Font R. L., Jenis E. H., Tuck K. D. Measles maculopathy associated with subacute sclerosing panencephalitis. Immunofluorescent and immuno-ultrastructural studies. Arch Pathol. 1973 Sep;96(3):168–174. [PubMed] [Google Scholar]
  4. Franken S. Measles and xerophthalmia in East Africa. Trop Geogr Med. 1974 Mar;26(1):39–44. [PubMed] [Google Scholar]
  5. Haltia M., Paetau A., Vaheri A., Erkkilä H., Donner M., Kaakinen K., Holmström T. Fatal measles encephalopathy with retinopathy during cytotoxic chemotherapy. J Neurol Sci. 1977 Jul;32(3):323–330. doi: 10.1016/0022-510x(77)90015-6. [DOI] [PubMed] [Google Scholar]
  6. Johnson B. L., Wisotzkey H. M. Neuroretinitis associated with herpes simplex encephalitis in an adult. Am J Ophthalmol. 1977 Apr;83(4):481–489. doi: 10.1016/0002-9394(77)90552-9. [DOI] [PubMed] [Google Scholar]
  7. Karel I., Otradovec J., Peleska M., Nevsímal O. Fluoroangiographic picture of the macular lesion in subacute sclerosing leukoencephalitis van Bogaert. Ophthalmologica. 1971;162(6):348–354. doi: 10.1159/000306304. [DOI] [PubMed] [Google Scholar]
  8. Krill A. E. Retinopathy secondary to rubella. Int Ophthalmol Clin. 1972 Summer;12(2):89–103. [PubMed] [Google Scholar]
  9. Landers M. B., 3rd, Klintworth G. K. Subacute sclerosing panencephalitis (SSPE). A clinicopathologic study of the retinal lesions. Arch Ophthalmol. 1971 Aug;86(2):156–163. doi: 10.1001/archopht.1971.01000010158008. [DOI] [PubMed] [Google Scholar]
  10. Lyon G. Examen ultra-structural du cerveau dans trois encephalopathies aigues et chroniques au cours de deficits immunitaires. Arch Fr Pediatr. 1972 Jun-Jul;29(6):641–654. [PubMed] [Google Scholar]
  11. Mellor D. Encephalitis and encephalopathy in childhood leukaemia. Dev Med Child Neurol. 1976 Feb;18(1):90–94. doi: 10.1111/j.1469-8749.1976.tb03609.x. [DOI] [PubMed] [Google Scholar]
  12. Minckler D. S., McLean E. B., Shaw C. M., Hendrickson A. Herpesvirus hominis encephalitis and retinitis. Arch Ophthalmol. 1976 Jan;94(1):89–95. doi: 10.1001/archopht.1976.03910030039011. [DOI] [PubMed] [Google Scholar]
  13. Murphy J. V., Yunis E. J. Encephalopathy following measles infection in children with chronic illness. J Pediatr. 1976 Jun;88(6):937–942. doi: 10.1016/s0022-3476(76)81045-1. [DOI] [PubMed] [Google Scholar]
  14. Nelson D. A., Weiner A., Yanoff M., DePeralta J. Retinal lesions in subacute sclerosing panencephalitis. Arch Ophthalmol. 1970 Nov;84(5):613–621. doi: 10.1001/archopht.1970.00990040615011. [DOI] [PubMed] [Google Scholar]
  15. Nihei K., Kamoshita S., Mizutani H., Kitayama T., Nishimura H. Atypical subacute sclerosing panencephalitis. Acta Neuropathol. 1977 May 16;38(2):163–166. doi: 10.1007/BF00688565. [DOI] [PubMed] [Google Scholar]
  16. Otradovec J. Das klinische Bild der zentralen chorioretinalen Veränderungen bei subakuter sklerosierender Leukoenzephalitis (van Bogaert) Ophthalmologica. 1969;157(6):427–441. doi: 10.1159/000305707. [DOI] [PubMed] [Google Scholar]
  17. Pullan C. R., Noble T. C., Scott D. J., Wisniewsk K., Gardner P. S. Atypical measles infections in leukaemic children on immunosuppressive treatment. Br Med J. 1976 Jun 26;1(6025):1562–1565. doi: 10.1136/bmj.1.6025.1562. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Sluga E., Budka H., Jellinger K., Pichler E. SSPE-like inclusion body disorder in treated childhood leukemia. Acta Neuropathol Suppl. 1975;Suppl 6:267–272. doi: 10.1007/978-3-662-08456-4_47. [DOI] [PubMed] [Google Scholar]
  19. Smyth D., Tripp J. H., Brett E. M., Marshall W. C., Almeida J., Dayan A. D., Coleman J. C., Dayton R. Letter: Atypical measles encephalitis in leukaemic children in remission. Lancet. 1976 Sep 11;2(7985):574–574. doi: 10.1016/s0140-6736(76)91821-3. [DOI] [PubMed] [Google Scholar]
  20. Wolinsky J. S., Swoveland P., Johnson K. P., Baringer J. R. Subacute measles encephalitis complicating Hodgkin's disease in an adult. Ann Neurol. 1977 May;1(5):452–457. doi: 10.1002/ana.410010508. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES