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Lukan Mishev, Aneta Misheva, Ioanna Misheva, Yanita Cankova, Anton Angelov; Varicela Zoster virus and Central serous retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5840.
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To find a causal conection between Varicela zoster virus and CSR and a possible rationale for treatment with Aciclovir.
A group of 25 patients with CSR diagnosed with SD-OCT (line scan, en-face and Lumbroso report) was treated with Aciclovir (2 grams per day,for 20 days) based on the high IGG antibodys in the serum,found by ELISA method .We have OCT exams on the 1-st week ,2-nd week and after 30 days.The second ELISA blood serum testing was performed after a 60 days period.Patients with pigment epithelial detachments along with the serous detachment were excluded.
In 23 patients we have observed a rapid resolution of the serous detachment (in the first 2 weeks period) wich was OCT monitored at every week.The treatment was with Aciclovir 2g. per day ,with no aditional medication or laser treatment. Two of the patients were with chronic recidive CSR and the resolution of the serous detachment took more then two week period ( 1 month)
In this study we have observed clinical conection between high serum IGG antibodys for Varicela zoster virus and the presence of active CSR .When this patients were treated with the specific drug ( Acuclovir) wich target theVaricela zoster virus(VCV) there was complete resolution of the CSR in very rappid manner wich mey proof that this is a effect of a treatment and not a spontaneous improvment. One of the proposed pathogenesys of the CSR is that there is a pigment epithelium impairment leading to disturbed metabolism as a major couse for acumulation of fluid between neurosensori retina and the pigment epithelium.In hystopathological studies was prooven that there can be a replication of Varicela zoster virus in the pigment epithelium of the retina. This can cause the impairment of the PE and we base our hypothesys for treatment and couse of CSR on that assumption.
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