Two Cases of Uveo-meningeal Syndrome

Dong Kyun Han; Sung Eun Kyung

doi:10.3341/jkos.2019.60.3.292

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Han and Kyung: Two Cases of Uveo-meningeal Syndrome

Case Report

J Korean Ophthalmol Soc 2019;60(3):292-297.

Published online: 25 September 2019

DOI: https://doi.org/10.3341/jkos.2019.60.3.292

Two Cases of Uveo-meningeal Syndrome

Dong Kyun Han, MD, Sung Eun Kyung, MD, PhD

Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea

Address reprint requests to Sung Eun Kyung, MD, PhD Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, #119 Dandae-ro, Dongnam-gu, Cheonan 31116, Korea Tel: 82-41-550-6497, Fax: 82-41-550-6894 E-mail: kseeye@hanmail.net

Received 5 July 2018 Revised 3 September 2018 Accepted 20 February 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report two cases of uveo-meningeal syndrome involving the retina, uvea, and optic disc in both eyes after viral meningitis.

Case summary

A 16-year-old female was referred to our department with blurred vision in both eyes. She was hospitalized in the pediatric ward with viral meningitis. She showed a norma best-corrected visual acuity (BCVA) and normal intraocular pressure in both eyes, but had severe inflammation in the anterior chamber on slit lamp examination, and optic disc edema and multiple whitish lesions on fundus examination. She was treated with intravenous antibiotic injections and steroid eye drops. After close observation, inflammation in the anterior chamber, optic disc edema, and the multiple whitish lesions in the retina were improved. A 27-year-old male who was treated for viral meningitis at the neurology department was referred to us with blurred vision in both eyes. His BCVAs were 0.7 (right eye) and 0.6 (left eye). The intraocular pressure was normal in both eyes. Slit lamp examination revealed inflammation in the anterior chamber and optic disc edema, and a fundus examination revealed multiple infiltrations. He received treatment for presumed herpes virus infection. After close observation, inflammation in the anterior chamber, optic disc edema, and multiple infiltrations with hemorrhage in the retina were improved.

Conclusions

Clinicians should consider the possibility of uveo-meningeal syndrome, which can cause inflammation in the uvea, retina, and optic disc simultaneous with viral meningitis accompanying blurred vision.

Keywords: Meningitis, Viral, Vision disorder, Uveo-meningeal syndrome

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Figure 1.

Color fundus photo of the first case. Right (A), left (B), both fundus photos showed multiple whitish lesions (arrows) and mild optic disc swelling. Fluorescence angiography (FAG) of the first case. Right (C, at 02:01.0), left (D, at 05:38.3). Both eyes showed vascular leakage in FAG and there were no hyperfluorescent lesions.

Figure 2.

Color fundus photos of the first case at 7 months later in right (A), left (B) eyes. Both photos showed disappearance of whitish lesions and normal optic disc.

Figure 3.

Color fundus photo of the second case. Right (A), left (B), both fundus photos showed multiple infiltrations with hemorrhage (arrows) and optic disc swelling.

Figure 4.

Color fundus photo of the second case at 3 months later in the right (A), left (B) eyes. Both photos showed disappearance of infiltrations and hemorrhage and normal optic disc.

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