Bilateral acute retinal necrosis caused by two separate viral etiologies

Williams, Andrew M.; Nguyen, Vincent Q.; Botsford, Benjamin; Eller, Andrew W.

doi:10.1016/j.ajoc.2020.100636

Cited by 3 publications

(6 citation statements)

References 20 publications

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“…Six patients (60%) showed bilateral affection, although the infection started predominantly unilaterally. However, in the further course, the partner eye was affected in up to 30–75% [ 1 , 10 , 11 , 12 , 13 ]. This was confirmed by our data.…”

Section: Discussionmentioning

confidence: 99%

“…Therapy includes parenteral antiviral therapy in the acute phase, followed by maintenance therapy to prevent recurrence and infestation of the fellow eye. As it is well known that the fellow eyes can also be affected in up to 75% of patients [ 10 , 11 , 12 ], an early antiviral treatment can have a protective effect on the fellow eye [ 13 ]. In addition, correct and early therapy may reduce the risk for complications such as retinal detachment [ 14 ], which occurs in up to 75% of all cases and presents a major cause of poor visual outcomes [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute Retinal Necrosis: Signs, Treatment, Complications and Outcome

et al. 2022

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Background: The Acute Retinal Necrosis (ARN) is an inflammatory, rapidly progressive necrotizing retinitis and vasculitis, most frequently caused by Varicella-Zoster-Virus (VZV), followed by Herpes-Simplex-Virus (HSV), Cytomegalovirus (CMV) and Epstein-Barr-Virus (EBV). The diagnosis is based on clinical signs that were first defined by the American Uveitis Society in 1994 that include one or more foci of retinal necrosis, rapid progression without treatment, circumferential progression, occlusive vasculopathy, and inflammatory signs of the vitreous and anterior chamber Methods: In this retrospective analysis, we included 16 eyes of 10 patients, six patients with simultaneous or delayed bilateral affection, treated for ARN. Status of disease, corrected distance visual acuity (CDVA, decimal), intraocular pressure (IOP), pathogen proof, therapy, and complications were evaluated at diagnosis and 3 months later. Results: In nine patients, the pathogen was identified (six VZV, two HSV, one CMV, one EBV). All patients were treated with systemic and intravitreal virustatic agents. In nine eyes with a CDVA of 0.2 ± 0.2 at hospital admission, vitrectomy was performed, and in seven eyes with CDVA of 0.5 ± 0.3, no vitrectomy was performed (p = 0.04). After 3 months, CDVA of the vitrectomized eyes decreased to 0.1 ± 0.1 vs. 0.4 ± 0.3 (p = 0.01) without vitrectomy. CDVA of fellow eyes affected was 0.6 ± 0.2 at initial presentation vs. 0.2 ± 0.2 for eyes affected first and 0.4 ± 0.3 vs. 0.1 ± 0.1 after 3 months. We observed several complications including retinal detachment, recurrence of the disease, and bulbar hypotony. Conclusion: For fellows eyes affected, diagnosis could be confirmed earlier, leading to a more successful treatment. The success of vitrectomy is difficult to evaluate because vitrectomy is most frequently performed just in the advanced stages of the disease. Early treatment with an appropriate approach is essential to avoid loss of vision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute Retinal Necrosis: Signs, Treatment, Complications and Outcome

et al. 2022

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“…ARN is characterized by discrete foci of retinal necrosis that progress rapidly in a circumferential fashion, with associated occlusive arterial vasculopathy and significant inflammation of the posterior and anterior segments of the eye [1]. It is most commonly associated with the varicella-zoster virus (VZV) and herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) [3]. Common sequelae of the disease include retinal breaks, detachments, and macular edema; patients with ARN tend to have a guarded visual prognosis [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…It is most commonly associated with the varicella-zoster virus (VZV) and herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) [3]. Common sequelae of the disease include retinal breaks, detachments, and macular edema; patients with ARN tend to have a guarded visual prognosis [3,4]. Among the most feared ARN complications is contralateral involvement, which may lead to significant visual disability and blindness [3].…”

Section: Introductionmentioning

confidence: 99%

“…Common sequelae of the disease include retinal breaks, detachments, and macular edema; patients with ARN tend to have a guarded visual prognosis [3,4]. Among the most feared ARN complications is contralateral involvement, which may lead to significant visual disability and blindness [3]. In a case series by Lei et al, 25 out of 30 patients with ARN developed the disease in the contralateral eye, most commonly within months of the initial presentation; however, a delayed involvement of the fellow eye, occurring after several years, was also described in a small subset of patients [5].…”

Section: Introductionmentioning

confidence: 99%

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Reactivation of Acute Retinal Necrosis following SARS-CoV-2 Infection

González

Rios

Pappaterra

et al. 2021

Case Reports in Ophthalmological Medicine

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Purpose. To report on a case of reactivation of acute retinal necrosis following SARS-CoV-2 infection. Methods. Observational case report. Observations. A 32-year-old female with a distant history of left retinal detachment secondary to necrotizing herpetic retinitis complained of right-eye vision loss, pain, redness, and photophobia. An ophthalmological examination revealed findings consistent with acute retinal necrosis of the right eye. A polymerase chain reaction (PCR) analysis of the right vitreous was positive for herpes simplex virus type 2 (HSV-2). A coronavirus disease 2019 (COVID-19) screening test using reverse transcriptase- (RT-) PCR was positive for SARS-CoV-2 RNA. Conclusions. Our case suggests that COVID-19 may cause a latent HSV infection to reactivate, causing contralateral involvement in patients with a prior history of HSV-associated acute retinal necrosis.

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Long-term follow-up of acute retinal necrosis with retinal detachment secondary to herpes simplex virus type 2 with a successful visual outcome

et al. 2023

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A man in his early 20s presented with acute loss of vision in his only eye, the left eye (OS), and was on oral steroids. He had lost vision in his right eye during his childhood and the cause was unknown. There was no history of trauma. Best-corrected visual acuity (BCVA) in OS was 20/100 and in the right eye was hand movements. OS showed non-granulomatous keratic precipitates on the cornea, anterior chamber flare 1+ and cell 1+, early cataract, vitreous haze and cells 2+ with nasal retinal detachment and superior full thickness retinitis. He underwent pars plana vitrectomy with intravitreal ganciclovir and barrage laser away from the necrotic retina. PCR for herpes simplex virus 2 was positive from the aqueous and vitreous sample. He was started on oral valacyclovir 1 g three times a day and continued on tapering dose of oral steroids. BCVA in OS at 6-month follow-up was 20/25.

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Bilateral acute retinal necrosis caused by two separate viral etiologies

Cited by 3 publications

References 20 publications

Acute Retinal Necrosis: Signs, Treatment, Complications and Outcome

Acute Retinal Necrosis: Signs, Treatment, Complications and Outcome

Reactivation of Acute Retinal Necrosis following SARS-CoV-2 Infection

Long-term follow-up of acute retinal necrosis with retinal detachment secondary to herpes simplex virus type 2 with a successful visual outcome

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