Progressive outer retinal necrosis-like retinitis in immunocompetent hosts

Abstract

We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids.

An imaging-based treatment algorithm for posterior focal retinitis

“…In both the patients, retinal detachment was noted in the eye with worse retinitis with complete loss of PL. 14 However, the fellow eye of these patients had visual improvement compared with at baseline. The third of these patients (case 5, Figure 2 ) directly presented to us.…”

“…Description of two of these cases (cases 3 and 4) has been published earlier. 14 Two of these patients were already on steroids prior to presenting to us. The lesions in these eyes were seen to rapidly progress centrifugally, probably as a result of steroid therapy.…”

Intravitreal bevacizumab for postviral fever retinitis: a novel approach for early resolution of macular oedema

“…The retinitis lesions might have resolved on its own as these patients were immunocompetent. We also feel that adding steroids without appropriate anti-infective agents in cases of infectious retinitis can lead to rapid centrifugal spreading and worsening of the retinitis as discussed in some studies 10. Three different patterns of fluid distribution have been reported in eyes with uveitic macular oedema based on OCT findings.…”

Sub-internal limiting membrane cavity following valsalva retinopathy resembling central serous chorioretinopathy

“…Sub-ILM hemorrhage may also be caused by proliferative diabetic retinopathy, anemia, thrombocytopenia, leukemia, subarachnoid hemorrhage (Terson syndrome), hypertension, ruptured retinal artery macroaneurysm, trauma, or shaken baby syndrome. [ 1 ] Sub-ILM cavity or ILM detachment may also occur in vitreomacular traction, retinitis,[ 4 ] or may not have an identifiable cause. [ 5 ]…”