[Bilateral acute retinal necrosis in a patient with acquired immunodeficiency syndrome]

J Fr Ophtalmol. 1995;18(10):625-33.
[Article in French]

Abstract

A case of bilateral progressive outer retinal necrosis occurred after herpes zoster ophthalmicus in a patient with acquired immunodeficiency syndrome. This case does not correspond to the classical picture of progressive outer retinal necrosis. The disease led to blindness despite intravenous therapy with acyclovir and foscarnet. PCR could not identify any virus in the aqueous humour, but VZV is evidenced in cerebrospinal fluid. Acute retinal necrosis is now clearly defined by the American Uveitis Society, which should allow to determine its incidence and risk factors. Herpes zoster usually precedes the acute outer retinal necrosis. The infectious theory (VZV, HSV, CMV) widely prevails over the immune theory. We prefer the virus genome identification in the aqueous humor or in the vitreous by PCR to confirm diagnosis rather than the specific antibody titration. Therapy consists in acyclovir, foscarnet and ganciclovir. But whatever the treatment, the visual prognosis is poor.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Acquired Immunodeficiency Syndrome / therapy
  • Antiviral Agents / therapeutic use
  • Herpes Zoster Ophthalmicus / etiology
  • Herpes Zoster Ophthalmicus / physiopathology
  • Herpes Zoster Ophthalmicus / therapy
  • Humans
  • Male
  • Middle Aged
  • Retinal Necrosis Syndrome, Acute / etiology*
  • Retinal Necrosis Syndrome, Acute / physiopathology
  • Retinal Necrosis Syndrome, Acute / therapy

Substances

  • Antiviral Agents