Affiliation:
1. Retina Specialists Victoria, Melbourne, Australia
2. Discipline of Orthoptics, La Trobe University, Melbourne, Australia
Abstract
Epstein-Barr virus (EBV), a herpes virus with a global prevalence exceeding 95%, is infrequently associated with ocular manifestations. We present a case of a 57-year-old Caucasian male who experienced acute bilateral vision loss following a preceding viral illness accompanied by fever. Initial corrected visual acuity was measured at 6/90, and imaging revealed bilateral retinal posterior pole and peripheral white spots, and hyper-reflective macular changes. Three weeks later, spontaneous improvement led to a visual acuity of 6/18, with minimal changes observed in the retinal disruption. Serology testing confirmed the presence of EBV antibodies. At the 6-month follow-up, the patient demonstrated further improvement with visual acuity of 6/12 and reduced foveal granularity. Remarkably, at the 19-month follow-up, the patient achieved near-complete resolution of vision to pre-infection levels, measuring 6/6 without receiving specific treatment. This case highlights a rare retinal manifestation of EBV characterized by an atypical presentation and underscores the significance of considering non-ocular causes when encountering unexplained vision loss.