Varicella-zoster virus retrobulbar optic neuritis in a patient with human immunodeficiency virus.

Objective: To determine the cause of bilateral retrobulbar optic neuritis followed by progressive outer retinal necrosis in a patient with human immunodeficiency virus (HIV).

Methods: Extensive ophthalmologic, neurologic, infectious disease, rheumatologic, and radiologic examinations were performed.

Results: Cerebrospinal fluid samples taken after the onset of bilateral retrobulbar optic neuritis and before the development of clinical progressive outer retinal necrosis disclosed varicella-zoster virus from polymerase chain reaction and viral culture.

Conclusions: Ophthalmologists and neurologists should consider varicella-zoster virus optic neuritis as a potential precursor of progressive outer retinal necrosis and as a cause of retrobulbar optic neuritis in patients infected with HIV.