New Diagnosis and Treatment Paradigms in Acute Retinal Necrosis

Kanoff, Justin; Sobrin, Lucia

doi:10.1097/iio.0b013e31822d6864

Cited by 22 publications

(24 citation statements)

References 38 publications

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“…34,35 Valganciclovir has excellent bioavailability and has been shown to be as efficacious as intravenous ganciclovir for the treatment of CMV retinitis. 36 Savant et al reported improvement of vision from 6/12 to 6/6 with regression of the VZV-ARN within one week of treatment with valganciclovir 900 mg BID.…”

Section: Treatmentmentioning

confidence: 99%

Advances in the Management of Acute Retinal Necrosis

Shantha

Weissman

Debiec

et al. 2015

International Ophthalmology Clinics

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Acute retinal necrosis is a viral syndrome characterized by a panuveitis with necrotizing retinitis that may be complicated by retinal detachment, vaso-occlusion, optic neuropathy, and other causes of decreased visual acuity. Polymerase chain reaction testing provides a rapid and sensitive method of identifying the viral etiology of acute retinal necrosis, which is most commonly caused by herpes simplex virus type 1, herpes simplex virus type 2, and varicella zoster virus. Prompt diagnosis and treatment is paramount to prevent further vision loss. We review the management of acute retinal necrosis including systemic, local intravitreal, and combination antiviral medications. We also discuss the appropriate and inappropriate use of corticosteroids, laser retinopexy, surgical therapy, and other adjunctive measures.

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Section: Treatmentmentioning

confidence: 99%

Advances in the Management of Acute Retinal Necrosis

Shantha

Weissman

Debiec

et al. 2015

International Ophthalmology Clinics

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“…In immunocompetent patients, necrotizing retinitis is caused most often by either varicella zoster virus (VZV) or herpes simplex virus (HSV). 1,2 In immunocompromised patients, such as those with the acquired immune deficiency syndrome (AIDS), cytomegalovirus (CMV) is an important cause of retinitis. 3–5 Regardless of cause, prompt diagnosis and treatment are required to prevent vision loss.…”

mentioning

confidence: 99%

Viral Retinitis following Intraocular or Periocular Corticosteroid Administration: A Case Series and Comprehensive Review of the Literature

Takakura

Tessler

Goldstein

et al. 2014

Ocular Immunology and Inflammation

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Purpose To describe viral retinitis following intravitreal and periocular corticosteroid administration. Methods Retrospective case series and comprehensive literature review. Results We analyzed 5 unreported and 25 previously published cases of viral retinitis following local corticosteroid administration. Causes of retinitis included 23 CMV (76.7%), 5 HSV (16.7%), and 1 each VZV and unspecified (3.3%). Two of 22 tested patients (9.1%) were HIV positive. Twenty-one of 30 (70.0%) cases followed one or more intravitreal injections of triamcinolone acetonide (TA), 4 (13.3%) after one or more posterior sub-Tenon injections of TA, 3 (10.0%) after placement of a 0.59-mg fluocinolone acetonide implant (Retisert), and 1 (3.3%) each after an anterior subconjunctival injection of TA (together with IVTA), an anterior chamber injection, and an anterior sub-Tenon injection. Mean time from most recent corticosteroid administration to development of retinitis was 4.2 months (median 3.8; range 0.25–13.0). Twelve patients (40.0%) had type II diabetes mellitus. Treatments used included systemic antiviral agents (26/30, 86.7%), intravitreal antiviral injections (20/30, 66.7%), and ganciclovir intravitreal implants (4/30, 13.3%). Conclusions Viral retinitis may develop or reactivate following intraocular or periocular corticosteroid administration. Average time to development of retinitis was 4 months, and CMV was the most frequently observed agent. Diabetes was a frequent co-morbidity and several patients with uveitis who developed retinitis were also receiving systemic immunosuppressive therapy.

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“…3 While herpetic infection is common, acute retinal necrosis is uncommon but does present with classic symptoms of ocular erythema, floaters, pain, and vision loss. [4][5][6] However, a patient with developmental-delay may not be able to articulate these complaints creating a dangerous situation where a rare condition caused by a ubiquitous virus could result in devastating morbidity to the patient.…”

mentioning

confidence: 98%

Acute Retinal Necrosis Presenting in Developmentally-delayed Patients with Neonatal Encephalitis: A Case Series and Literature Review

Okafor

Thinda

et al. 2016

Ocular Immunology and Inflammation

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We report three cases of patients with developmental-delay from neonatal herpetic encephalitis and/or meningitis who presented years later with acute retinal necrosis due to herpes simplex virus. The diagnosis was delayed in all cases due to the patients' inability to verbalize their ocular complaints and cooperate with eye examinations. This case series documents the clinical course, pathophysiologic mechanism, and treatment of acute retinal necrosis in this patient population. Clinicians should understand the importance of prudent consideration of acute retinal necrosis in patients with a history of neonatal herpetic encephalitis and/or meningitis presenting with a red eye.

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New Diagnosis and Treatment Paradigms in Acute Retinal Necrosis

Cited by 22 publications

References 38 publications

Advances in the Management of Acute Retinal Necrosis

Advances in the Management of Acute Retinal Necrosis

Viral Retinitis following Intraocular or Periocular Corticosteroid Administration: A Case Series and Comprehensive Review of the Literature

Acute Retinal Necrosis Presenting in Developmentally-delayed Patients with Neonatal Encephalitis: A Case Series and Literature Review

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