J Korean Ophthalmol Soc.  2012 Aug;53(8):1186-1189. 10.3341/jkos.2012.53.8.1186.

A Case of Acute Retinal Necrosis Following Herpes Simplex Virus (HSV) Encephalitis

• An TS
• Kwon SI
• Hwang DJ
• Park IW

• KMID: 2215966
• DOI: http://doi.org/10.3341/jkos.2012.53.8.1186

Abstract

PURPOSE
To report a case of unilateral acute retinal necrosis (ARN) following herpes simplex virus (HSV) encephalitis.
CASE SUMMARY
A 19-year-old man previously diagnosed with HSV encephalitis presented with a headache and visual loss in his left eye. On the initial visit, slit-lamp examination showed conjunctival injection and inflammatory cells (3+) in the anterior chamber of the left eye. Funduscopic examination showed optic disc swelling, multiple yellow-whitish spots in the peripheral retina and retinal vascular sheathing. After the patient was diagnosed with ARN, intravenous acyclovir (1,500 mg/m2/day) was administered. Because retinal detachment and multiple retinal breaks were found during the treatment period, the authors performed barrier laser treatment in the peripheral retina. At that time, no retinal necrosis was observed in the patient's right eye. The retinal lesions regressed, and no new retinal lesion was observed in the left eye, during the follow-up period.
CONCLUSIONS
We report a case of ARN in a patient with HSV encephalitis. Ophthamologist should perform a thorough ophthalmic examination in a patient diagnosed with HSV encephalitis.

Keyword

Acute retinal necrosis; Herpes simplex virus; Herpetic encephalitis

MeSH Terms

Acyclovir
Anterior Chamber
Encephalitis
Encephalitis, Herpes Simplex
Eye
Follow-Up Studies
Headache
Herpes Simplex
Humans
Methylmethacrylates
Necrosis
Patient Rights
Polystyrenes
Retina
Retinal Detachment
Retinal Necrosis Syndrome, Acute
Retinal Perforations
Retinaldehyde
Simplexvirus
Young Adult
Acyclovir
Methylmethacrylates
Polystyrenes
Retinaldehyde

Figure

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  Figure 1 Brain MRI enhanced sequence consistent with lesions of herpes simplex encephalitis.

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  Figure 2 (A) In initial presentations, fundus photographs shows disc swelling and retinal vascular sheathing. (B) There are multiple, cream-colored, confluent necrotic lesions and hemorrhage at the periphery.

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