Table 15.
Demographics and clinical characteristics of West Nile virus chorioretinitis
| Author (year) |
Age (years) |
Gender | Laterality | Associated conditions |
Method of diagnosis |
Symptoms | Signs | VA at presentation |
Treatment | Complications | Duration of follow- up (months) |
VA at last visit |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bains et al (2003)19 | 62 | F | B | WNV infection | Serology | Floaters | Deep, flat, creamy whitish yellow outer chorioretinal lesions, moderate vitritis, small intraretinal hemorrhages | OD 20/25; OS 20/40 | Topical prednisolone | Chorioretinal scars | 0.5 | OD 20/25; OS 20/30 |
| Hershberger et al (2003)88 | 61 | F | B | WNV infection | Serology | Blurred vision | AC cells and flare, creamy/partially atrophic nummular chorioretinal lesions | OD 20/30; OS 20/25 | Topical prednisolone | Chorioretinal scars | 1 | NR |
| 56 | M | B | WNV meningoencephalitis | Serology | Floaters | Optic disk edema, retinal hemorrhages, small white deep chorioretinal lesions | OU 20/25 | Topical prednisolone | Chorioretinal scars | 4 | NR | |
| Anninger et al (2003)13 | 55 | F | B | WNV meningoencephalitis | Serology | Blurred vision | Diffuse creamy yellow chorioretinal lesions | OD 20/80; OS 20/50 | Nil | Visual field loss, optic neuritis | 6 | OU 20/25 |
| Anninger et al (2004)14 | 55 | F | B | WNV meningoencephalitis | Serology | Visual field loss, blurred vision, ocular pain | Pale optic nerves, vitreous cavity cells, diffuse creamy yellow chorioretinal lesions | OD 20/80; OS 20/40 | Nil | Optic atrophy | 12 | OD 20/60; OS: “recovered” |
| Khairallah et al (2004)122 | Mean: 53; range: 22–74 | M: 20; F: 9 | B: 23 | WNV infection/meningoencephalitis | Serology | Floaters: 8; blurred vision: 6; redness: 6; visual field defect: 1; diplopia: 1 | Bilateral multifocal chorioretinitis: 23; retinal hemorrhages: 21; vascular sheathing: 4; optic disk swelling: 2 | Mean: 20/32; range: 20/20–20/100 | Ribavirin | Chorioretinal scars | NR | Mean: 20/25 |
| Khairallah et al (2006)126 | Mean: 47.2; range: 29–62 | M: 7; F: 5 | B: 12 | WNV infection | Serology | Floaters: 4; blurred vision: 2; redness: 2 | Multifocal chorioretinitis with linear clustering of noncontiguous, contiguous, or confluent lesions | Mean: 20/25; range: 20/20–20/50 | NR | NR | NR | NR |
| Garg et al (2006)69 | 44 | F | B | WNV meningoencephalitis | CSF | Vision loss | Arterial attenuation, intraretinal hemorrhages, cotton wool spots, ischemic whitening of macula | OD 20/30; OS CF | NR | NR | NR | NR |
| 68 | F | B | WNV infection | Serology | Blurred vision | Arterial attenuation, scattered chorioretinal lesions, intraretinal hemorrhages | OD 20/60; OS 20/25 | |||||
| 57 | M | B | WNV meningoencephalitis | CSF | Vision loss | Arterial attenuation, intraretinal hemorrhages, ischemic whitening of macula, cotton wool spots, retinal/disk neovascularization | OD 20/25; OS HM | Panretinal photocoagulation, vitrectomy | Tractional RD, vitreous hemorrhage | 18 | OD 20/100; OS 20/200 | |
| Khairallah et al (2007)127 | Median: 57 | M: 17; F:15 | NR | WNV meningoencephalitis: 27 | Serology | NR | Chorioretinal lesions | NR | NR | CME | 24 | NR |
| Seth et al (2007)217 | 81 | M | B | WNV encephalitis | Serology | Decreased vision | Mild vitritis, round, cream-colored chorioretinal lesions | OD: NR; OS 20/400 | Intravitreal bevacizumab for CNV | Chorioretinal scars, CNV | 59 | OS: HM 2 ft |
| Sivakumar et al (2013)224 | Mean: 37; median: 35; range: 9–65 | M: 22; F: 15 | B: 14; U: 23 | WNV meningoencephalitis: 2 | Serology | Decreased vision, ocular pain | Areas of discrete, superficial, white multifocal choroiditis, retinal edema, vasculitis, retinal hemorrhages, optic disk hyperemia, neuroretinitis, serous RD | Mean logMAR: 1.26 | Oral prednisolone | Retinal atrophy, vascular occlusion, retinitis, neovascularization | Range:2–6 | Mean logMAR: 1.00; improved: 16; same: 28; worsened: 2 |
| Summary; n, % | Mean: 56.4; range: 9–74 | M: 69 (58.0); F: 50 (42.0) | B: 58 (71.6); U: 23 (28.4) | WNV infection/meningoencephalitis | Serology, CSF | Floaters, blurred vision, redness, visual field defect, diplopia, pain | White-yellow chorioretinal lesions, retinal hemorrhages, retinal/optic disk edema, vasculitis, serous RD, neuroretinitis | Range: 20/20-HM | Topical/oral prednisolone, photocoagulation, vitrectomy | Chorioretinal scars, optic atrophy, RD, vitreous hemorrhage, CNV, neovascularization | Range: 0.5–59 | Majority improved |
AC, anterior chamber; B, bilateral; CF, counting fingers; CME, cystoid macular edema; CNV, choroidal neovascularization; CSF, cerebrospinal fluid; F, female; HM, hand movement; M, male; NR, not reported; OD, oculus dexter; OS, oculus sinister; OU, oculus uterque; RD, retinal detachment; U, unilateral; VA, visual acuity; WNV, West Nile virus.