Acute angle-closure glaucoma with choroidal effusion revealing a hantavirus infection: Description of ultrasound biomicroscopy imagery and optical coherence tomography Visante

Eur J Ophthalmol. 2021 Jan;31(1):NP4-NP8. doi: 10.1177/1120672119858895. Epub 2019 Jul 1.

Abstract

Purpose: To report a case of bilateral angle-closure associated with systemic hantavirus infection.

Materials and methods: A 32-year-old Caucasian man was referred with blurred vision, fever, cough, dyspnea and thrombocytopenia. Ophthalmologic examination revealed myopic shift, elevated intraocular pressure (30 mmHg right eye and 24 mmHg left eye), corneal edema, iridocorneal angle closure and shallow anterior chamber. Ciliochoroidal effusion was detected on anterior segment optical coherence tomography and ultrasound biomicroscopy. Serologic test and polymerase chain reaction confirmed the diagnosis of hantavirus infection and the serotype Puumala. On the sixth day after he started topical anti-glaucoma and cycloplegic medications, the anterior chamber and iridocorneal angles were normalized with disappearance of ciliochoroidal effusion.

Conclusion: Puumala hantavirus infection is an exceptional cause of acute bilateral angle-closure combined with ciliochoroidal effusion.

Keywords: Glaucoma; Puumala; choroidal effusion; hantavirus.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adrenergic alpha-2 Receptor Agonists / therapeutic use
  • Adult
  • Antibodies, Viral / blood
  • Brimonidine Tartrate / therapeutic use
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Choroidal Effusions / diagnosis
  • Choroidal Effusions / drug therapy
  • Choroidal Effusions / virology*
  • Eye Infections, Viral / diagnosis
  • Eye Infections, Viral / drug therapy
  • Eye Infections, Viral / virology*
  • Glaucoma, Angle-Closure / diagnosis
  • Glaucoma, Angle-Closure / drug therapy
  • Glaucoma, Angle-Closure / virology*
  • Hantavirus Infections / diagnosis
  • Hantavirus Infections / drug therapy
  • Hantavirus Infections / virology*
  • Humans
  • Intraocular Pressure
  • Male
  • Microscopy, Acoustic
  • Myopia / diagnosis
  • Myopia / drug therapy
  • Myopia / virology
  • Orthohantavirus / genetics
  • Orthohantavirus / isolation & purification*
  • RNA, Viral / blood
  • RNA, Viral / genetics
  • Real-Time Polymerase Chain Reaction
  • Tomography, Optical Coherence
  • Tonometry, Ocular

Substances

  • Adrenergic alpha-2 Receptor Agonists
  • Antibodies, Viral
  • Carbonic Anhydrase Inhibitors
  • RNA, Viral
  • Brimonidine Tartrate