Progressive outer retinal necrosis syndrome: a comprehensive review of its clinical presentation, relationship to immune system status, and management

Austin, Robert B.

doi:10.1016/s0953-4431(00)00052-7

Cited by 64 publications

(78 citation statements)

References 50 publications

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“…1 In a majority of previously reported patients, generalized herpes zoster infections were found prior to or coincident with PORN. 2,3 As such, hematogenous dissemination during herpes zoster eruptions has been suggested as a predisposing factor.…”

mentioning

confidence: 95%

“…These patients were immunocompromised due to therapy for idiopathic thrombocytopenic purpura (ITP), cutaneous non-Hodgkin's lymphoma, rheumatoid arthritis and renal transplantation. 1 To our knowledge no case of PORN, with laboratory confirmation of VZV involvement, occurring after allogeneic stem cell transplantation (allo-SCT) has been reported until now. Here, we report a laboratory confirmed case of PORN following disseminated VZV infection in an allo-SCT patient.…”

mentioning

confidence: 98%

“…Progressive outer retinal necrosis (PORN) is described as a distinct form of VZV necrotizing chorioretinitis and is found almost exclusively in patients with acquired immunodeficiency syndrome (AIDS). [1][2][3][4] However, a few cases in non-AIDS patients have been reported. These patients were immunocompromised due to therapy for idiopathic thrombocytopenic purpura (ITP), cutaneous non-Hodgkin's lymphoma, rheumatoid arthritis and renal transplantation.…”

mentioning

confidence: 99%

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Varicella zoster virus (VZV)-related progressive outer retinal necrosis (PORN) after allogeneic stem cell transplantation

Kalpoe

Dehn

Bollemeijer

et al. 2005

Bone Marrow Transplant

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confidence: 95%

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confidence: 98%

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confidence: 99%

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Varicella zoster virus (VZV)-related progressive outer retinal necrosis (PORN) after allogeneic stem cell transplantation

Kalpoe

Dehn

Bollemeijer

et al. 2005

Bone Marrow Transplant

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“…La infección por VHZ es habitualmente de fácil manejo pero, en pacientes gravemente inmunosuprimidos (linfocitos T-CD4 < 100 céls/mL), se puede asociar a diseminación al SNC con vasculitis, leucoencefalitis multifocal, ventriculitis, mielitis y mielo-radiculitis, neuritis . La necrosis exterior retiniana progresiva se presenta en este mismo contexto de paciente y debe diferenciarse de la necrosis retiniana aguda por VHS [107][108][109] . La necrosis exterior retiniana progresiva cursa con mí-nima infl amación del humor acuoso y vítreo, ausencia de vasculitis retinal y múltiples lesiones periféricas pequeñas en las capas superfi ciales de retina.…”

Section: Diagnósticounclassified

“…La necrosis exterior retiniana progresiva cursa con mí-nima infl amación del humor acuoso y vítreo, ausencia de vasculitis retinal y múltiples lesiones periféricas pequeñas en las capas superfi ciales de retina. Estas lesiones confl uyen rápidamente, adelgazan la retina, generan necrosis y desprendimiento con pérdida visual 108 . La gran mayoría de las veces el diagnóstico se establece clínicamente; en los casos con compromiso sistémico se debe recurrir a la biopsia con estudio histopatológico y RPC confi rmatoria para virus varicela-zoster.…”

Section: Diagnósticounclassified

Diagnóstico y tratamiento de infecciones oportunistas en el paciente adulto con infección por VIH/SIDA

2011

Rev. chil. infectol.

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Progressive Outer Retinal Necrosis

Gore¹,

Gore²,

Visser³

2012

Arch Ophthalmol

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Objective: To describe the functional and anatomic outcomes of progressive outer retinal necrosis treated with intravitreal ganciclovir sodium injections. Methods: A retrospective, interventional case series of all patients fitting established clinical diagnostic criteria for progressive outer retinal necrosis was conducted at a single institution in South Africa. Eyes with salvageable vision were treated with repeated intravitreal ganciclovir injections until regression was achieved or the eye lost light perception. Pars plana vitrectomy was performed when retinal detachments failed to resolve spontaneously. The main outcome measures were visual acuity (VA) and response to intravitreal ganciclovir. Results: Thirty-nine patients (67 eyes), all of whom were HIV-positive (median CD4 ϩ T-lymphocyte count, 30/ µL), were included; 12 patients (31%) died during the study period. Twenty-eight of 36 patients (78%) had a recent history of cutaneous varicella zoster virus infection. At the initial evaluation, the mean VA was 6/120, with 12 eyes (18%) having already lost perception of light. Intravitreal ganciclovir injections were started immediately in all salvageable eyes (n=50). Improvements in visual outcomes trended toward significance in eyes responding early (Յ21 days), achieving a median final VA of 6/36 (P=.046). Retinal detachment occurred in 34 eyes (51%), predicating a significantly worse visual outcome (PϽ.001). Excluding eyes with no light perception at the start of the study period, median final VA was hand movements (range, 6/4 to no light perception); 9 eyes lost perception of light despite treatment. Conclusions: Progressive outer retinal necrosis remains a devastating condition, often with acute and profound loss of vision. Intravitreal ganciclovir may offer a more targeted approach and, compared with earlier reports using systemic therapy alone, may result in better visual outcomes.

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Progressive outer retinal necrosis syndrome: a comprehensive review of its clinical presentation, relationship to immune system status, and management

Cited by 64 publications

References 50 publications

Varicella zoster virus (VZV)-related progressive outer retinal necrosis (PORN) after allogeneic stem cell transplantation

Varicella zoster virus (VZV)-related progressive outer retinal necrosis (PORN) after allogeneic stem cell transplantation

Diagnóstico y tratamiento de infecciones oportunistas en el paciente adulto con infección por VIH/SIDA

Progressive Outer Retinal Necrosis

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