Delayed onset of bilateral acute retinal necrosis syndrome: a 46-year interval

Semin Ophthalmol. 2015 Mar;30(2):146-9. doi: 10.3109/08820538.2013.833265. Epub 2013 Oct 11.

Abstract

Background: Acute retinal necrosis (ARN) syndrome is an uncommon, severe form of retinitis that is caused by the herpes virus family. Bilateral acute retinal necrosis (BARN) at delayed onset is rare.

Methods: A retrospective, interventional case is described in a 64-year-old man complaining of blurred vision in the left eye. The patient had a history of presumed ARN in the right eye at the age of 18 years.

Results: The reduced visual acuity and the ocular fundus signs lead us to the diagnosis of delayed-onset BARN. Intravenous and intravitreal antiviral therapy, corticosteroid and antiplatelet treatment were administered until recovering final visual acuity.

Conclusions: This report represents the longest reported interval of ARN quiescence with eventual bilateral involvement and illustrates the importance of long-term patient follow-up in immunocompetent patients.

Keywords: Acyclovir; BARN; foscarnet; herpes virus; intravitreal injection.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use
  • DNA, Viral / genetics
  • Follow-Up Studies
  • Herpes Zoster Ophthalmicus / diagnosis*
  • Herpes Zoster Ophthalmicus / drug therapy
  • Herpes Zoster Ophthalmicus / virology
  • Herpesvirus 3, Human / genetics
  • Herpesvirus 3, Human / isolation & purification*
  • Humans
  • Injections, Intravenous
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Retinal Detachment / diagnostic imaging
  • Retinal Necrosis Syndrome, Acute / diagnosis*
  • Retinal Necrosis Syndrome, Acute / drug therapy
  • Retinal Necrosis Syndrome, Acute / virology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Ultrasonography
  • Vision Disorders / diagnosis*
  • Vision Disorders / drug therapy
  • Vision Disorders / virology
  • Visual Acuity / physiology

Substances

  • Antiviral Agents
  • DNA, Viral