Acute Retinal Necrosis: a rare devastating disease
Purpose
To present a case of an acute retinal necrosis (ARN), a rare devastating rapidly progressive retinitis, mainly caused by the viruses of the Herpesviridae family.
Methods
Clinical case presentation.
Results
59-year-old hypertensive man that complained about a visual acuity (VA) decreased on his left eye during a blepharoplasty surgery follow-up. Symptoms had started by the time he was submitted to surgery 2 months before. He had a VA of 20/80 and at the objective evaluation 1+ anterior chamber cells along with a 3+ vitreous densification, peripheral 360º retinal necrosis with vasculitis spots sparing most of the posterior pole (but with extension to the inferior vascular arcade) and some atrophic holes superiorly. He was diagnosed with ARN, hospitalized and medicated with high dose intravenous acyclovir associated with topical corticosteroid and atropine. Oral prednisolone was initiated two days after. He was then treated with laser therapy to prevent retinal detachment. At his last evaluation, 2 months after the diagnosis, he was still on the oral medication with an improvement on his VA to 20/40 with less dense vitritis (1+). Superior retina anterior to the laser was detached.
Conclusion
ARN usually affects immunocompetent healthy adults between 50 and 70 years old. It presents with anterior and posterior segment inflammation. In this clinical case the diagnosis was made in an advanced state of the disease since our patient already had retinal necrosis at 360º with extension to the inferior vascular arcade and atrophic holes. Nevertheless, he was responsive to the treatment with an improvement of his VA. Though not consensual in these patients, laser therapy was important to prevent retinal detachment progression.
Conflict of interest
No
Authors 1
Last name
PESTANA AGUIAR
Initials of first name(s)
C
Department
Ophthalmology
City
Santa Maria da Feira
Country
Portugal
Authors 2
Last name
Miranda
Initials of first name(s)
V
Department
Ophthalmology
City
Santa Maria da Feira
Country
Portugal
Authors 3
Last name
Ambrósio
Initials of first name(s)
J
Department
Ophthalmology
City
Santa Maria da Feira
Country
Portugal
Authors 4
Last name
Chibante-Pedro
Initials of first name(s)
J
Department
Ophthalmology
City
Santa Maria da Feira
Country
Portugal
Authors 5
Last name
Ruão
Initials of first name(s)
M
Department
Ophthalmology
City
Santa Maria da Feira
Country
Portugal
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