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Orbital apex syndrome: an unusual complication of herpes zoster ophthalmicus

Overview of attention for article published in BMC Infectious Diseases, January 2015
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Title
Orbital apex syndrome: an unusual complication of herpes zoster ophthalmicus
Published in
BMC Infectious Diseases, January 2015
DOI 10.1186/s12879-015-0760-z
Pubmed ID
Authors

Chun-Yuan Lee, Hung-Chin Tsai, Susan Shin-Jung Lee, Yao-Shen Chen

Abstract

BackgroundHerpes zoster ophthalmicus is defined as herpes zoster involvement of the ophthalmic division of the trigeminal nerve. Ocular involvement occurs in 20¿70% of patients with herpes zoster ophthalmicus and may include blepharitis, keratoconjunctivitis, iritis, scleritis, and acute retinal necrosis. Orbital apex syndrome is a rare but severe ocular complication of herpes zoster ophthalmicus. We present here the first reported case of herpes zoster ophthalmicus complicated by orbital apex syndrome in a patient from Taiwan.Case presentationA 78-year-old man initially presented with patchy erythema and herpetiform vesicles on his left forehead and upper eyelid. He subsequently developed left-sided ocular complications including reduced visual acuity, anisocoria, ptosis, and complete ophthalmoplegia. Orbital magnetic resonance imaging (MRI) was performed on day 6 of admission to search for signs of the common causes of orbital apex syndrome such as hemorrhage, neoplasm, and cavernous sinus thrombosis. The MRI showed only orbital myositis and enhancement of the retro-orbital optic nerve sheath. The patient was diagnosed with herpes zoster ophthalmicus complicated by orbital apex syndrome. Although the ocular complications partially resolved after systemic antiviral therapy for 15 days and steroid therapy tapered over 12 weeks, there was residual limitation of abduction and paralysis of the left upper eyelid at follow-up at 180 days after the onset of symptoms. The orbital MRI findings at 180 days showed no significant changes compared with the MRI findings on day 6 of admission.ConclusionsPrimary care physicians should be aware of this rare but potentially sight-threatening complication of herpes zoster ophthalmicus. The appropriate therapy for orbital apex syndrome due to herpes zoster ophthalmicus and the potential outcomes of this condition require further investigation.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 14 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 14 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 3 21%
Student > Bachelor 2 14%
Other 2 14%
Student > Master 2 14%
Student > Doctoral Student 2 14%
Other 3 21%
Readers by discipline Count As %
Medicine and Dentistry 10 71%
Unspecified 2 14%
Agricultural and Biological Sciences 1 7%
Veterinary Science and Veterinary Medicine 1 7%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 February 2015.
All research outputs
#3,935,436
of 4,698,042 outputs
Outputs from BMC Infectious Diseases
#2,168
of 2,569 outputs
Outputs of similar age
#132,140
of 164,328 outputs
Outputs of similar age from BMC Infectious Diseases
#124
of 152 outputs
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