Patients With an Acute Zonal Occult Outer Retinopathy–like Illness Rapidly Improve With Valacyclovir Treatment

PurposeTo describe 3 cases of an acute zonal occult outer retinopathy–like illness responsive to valacyclovir hydrochloride.DesignRetrospective, interventional case series.MethodsThree patients were treated with valacyclovir and monitored by clinical examination, Goldmann visual field testing, and electroretinography.ResultsPatients with an acute zonal occult outer retinopathy–like illness presented following progressive vision loss. This course was immediately reversed by treatment with oral valacyclovir, and visual acuity and visual field improved significantly at 1 week and 1 month. Patients remained stable without treatment during a follow-up period ranging from 1 to 3 years.ConclusionsSome conditions with features of acute zonal occult outer retinopathy may be attributable to a subacute herpetic viral infection that is responsive to oral antiviral medication.