The Progressive Outer Retinal Necrosis Syndrome

Engstrom, Robert E.; Holland, Gary N.; Margolis, Todd P.; Muccioli, Cristina; Lindley, Janette; Belfort, Rubens; Holland, Simon; Johnston, W. H.; Wolitz, Richard A.; Kreiger, Allan E.

doi:10.1016/s0161-6420(94)31142-0

Cited by 238 publications

(64 citation statements)

References 26 publications

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“…The reports on patients with rheumatoid arthritis and on the one patient with idiopathic thrombocytopenic purpura were also bilateral [11, 13, 14]. PORN tends to be bilateral with time in HIV patient series (61–70% of patients) [1, 2], which was not the case in our patient. In addition, our patient could not report a previous or concurrent extraocular VZV manifestation, unlike 67–75% of patients in HIV patient series [1, 2].…”

Section: Discussionmentioning

confidence: 40%

“…The retinal symptoms could have been initially misleading, but the immunosuppressed status of the patient prompted the exploration of PORN in this non-HIV-infected patient. The patient's symptoms (painless rapidly progressive visual loss), the appearance of retinal lesions (multifocal, coalescent and peripheral), the lack of anterior and posterior inflammation, the lack of response to treatment and the presence of VZV in aqueous and vitreous humors without another herpes virus (cytomegalovirus, herpes simplex virus) were typical of PORN [1, 2, 3, 4], in a context of immunosuppressive treatments recently introduced with azathioprine and prednisone. The context of recently introduced azathioprine associated with corticosteroids supports this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Affected patients complain of blurring vision or vague visual loss (54%), constriction of the visual field or loss of peripheral vision (28%), floaters (1%), pain (6%), or are asymptomatic (11%) [1]. The fundoscopic examination is characterized by multifocal retinal opacities starting at the peripheral retina, involving the posterior pole in 30% of cases, being rapidly coalescent and progressing to complete retinal necrosis [1, 2]. The retinitis tends to be bilateral with time (61% of patients), i.e.…”

Section: Introductionmentioning

confidence: 99%

“…The retinitis tends to be bilateral with time (61% of patients), i.e. within 4 weeks in the study by Engstrom et al [1]. Intraocular inflammation and vasculitis are usually absent, which differentiates PORN from VZV acute retinal necrosis affecting non-immunosuppressed patients [3].…”

Section: Introductionmentioning

confidence: 99%

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Progressive Outer Retinal Necrosis and Immunosuppressive Therapy in Myasthenia Gravis

Coisy

Ebran

Miléa

2014

Case Rep Ophthalmol

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Introduction: Progressive outer retinal necrosis (PORN) is a rare but devastating infectious retinitis associated with varicella zoster virus (VZV) and responsible for severe visual loss. Case Report: A 59-year-old man treated for generalized myasthenia with oral azathioprine and prednisone presented with severe unilateral necrotizing retinitis. Polymerase chain reaction of the aqueous and vitreous humors was diagnostic for VZV PORN. Conclusion: VZV PORN is a severe potential ocular complication of immunosuppression, prompting urgent diagnosis and appropriate treatment.

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Section: Discussionmentioning

confidence: 40%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Progressive Outer Retinal Necrosis and Immunosuppressive Therapy in Myasthenia Gravis

Coisy

Ebran

Miléa

2014

Case Rep Ophthalmol

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“…While the prevalence of PORN has decreased in the HAART era, it often resulted in NLP vision in affected eyes previously. [ 24 ]…”

Section: Viral Uveitismentioning

confidence: 99%

Infectious Uveitis

Lin

2015

Curr Ophthalmol Rep

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Infectious uveitis is one of the most common and visually devastating causes of uveitis in the US and worldwide. This review provides a summary of the identification, treatment, and complications associated with certain forms of viral, bacterial, fungal, helminthic, and parasitic uveitis. In particular, this article reviews the literature on identification and treatment of acute retinal necrosis due to herpes simplex virus, varicella virus, and cytomegalovirus. While no agreed-upon treatment has been identified, the characteristics of Ebola virus panuveitis is also reviewed. In addition, forms of parasitic infection such as Toxoplasmosis and Toxocariasis are summarized, as well as spirochetal uveitis. Syphilitic retinitis is reviewed given its increase in prevalence over the last decade. The importance of early identification and treatment of infectious uveitis is emphasized. Early identification can be achieved with a combination of maintaining a high suspicion, recognizing certain clinical features, utilizing multi-modal imaging, and obtaining specimens for molecular diagnostic testing.

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Inadvertent Instillation of Nonophthalmic Antiseptic Drops Due to Packaging Similarity

Steinemann¹

1998

Arch Ophthalmol

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The Progressive Outer Retinal Necrosis Syndrome

Cited by 238 publications

References 26 publications

Progressive Outer Retinal Necrosis and Immunosuppressive Therapy in Myasthenia Gravis

Progressive Outer Retinal Necrosis and Immunosuppressive Therapy in Myasthenia Gravis

Infectious Uveitis

Inadvertent Instillation of Nonophthalmic Antiseptic Drops Due to Packaging Similarity

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