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An, Kwon, Hwang, and Park: A Case of Acute Retinal Necrosis Following Herpes Simplex Virus (HSV) Encephalitis
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(8): 1186-1189.

Published online: 17 August 2012

DOI: https://doi.org/10.3341/jkos.2012.53.8.1186

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

Tae Su An, MD1, Soon Il Kwon, MD1, Duck Jin Hwang, MD2, In Won Park, MD, PhD1

1Department of Ophthalmology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

2Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Address reprint requests to In Won Park, MD, PhD. Department of Ophthalmology, Hallym University Sacred Heart Hospital, #22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 431-070, Korea. Tel: 82-31-380-3834, Fax: 82-31-380-3837, piw@korea.com

Received 11 May 2011       Accepted 19 June 2012

Copyright © 2012 The Korean Ophthalmological Society

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.

Keywords: Acute retinal necrosis, Herpes simplex virus, Herpetic encephalitis

Figures and Tables

Figure 1
Brain MRI enhanced sequence consistent with lesions of herpes simplex encephalitis.
jkos-53-1186-g001
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.
jkos-53-1186-g002

References

1. Urayama A, Yamada N, Sasaki T, et al. Unilateral acute uveitis with retinal periarteritis and detachment. Jpn J Clin Ophthalmol. 1971. 25:607–619.
2. Culbertson WW, Blumenkranz MS, Haines H, et al. The acute retinal necrosis syndrome. Part 2: Histopathology and etiology. Ophthalmology. 1982. 89:1317–1325.
3. Holland GN. Executive Committee of the American Uveitis Society. Standard diagnostic criteria for the acute retinal necrosis syndrome. Am J Ophthalmol. 1994. 117:663–667.
4. Cottet L, Kaiser L, Hirsch HH, Baglivo E. HSV2 acute retinal necrosis: diagnosis and monitoring with quantitative polymerase chain reaction. Int Ophthalmol. 2009. 29:199–201.
5. Kianersi F, Masjedi A, Ghanbari H. Acute Retinal Necrosis after Herpetic Encephalitis. Case Report Ophthalmol. 2010. 1:85–89.
6. Sugitani K, Hirano Y, Yasukawa T, et al. Unilateral Acute Retinal Necrosis 2 Months After Herpes Simplex Encephalitis. Ophthalmic Surg Lasers Imaging. 2010. 9:1–5.
7. Landry ML, Mullangi P, Nee P, Klein BR. Herpes simplex virus type 2 acute retinal necrosis 9 years after neonatal herpes. J Pediatr. 2005. 146:836–838.
8. Preiser W, Doerr HW, Buxbaum S, et al. Acute retinal necrosis six years after herpes simplex encephalitis: an elusive immune deficit suggested by insufficient test sensitivity. J Med Virol. 2004. 73:250–255.
9. Levinson RD, Reidy R, Chiu MT. Acute retinal necrosis after neonatal herpes encephalitis. Br J Ophthalmol. 1999. 83:123–124.
10. Pavésio CE, Conrad DK, McCluskey PJ, et al. Delayed acute retinal necrosis after herpetic encephalitis. Br J Ophthalmol. 1997. 81:415–416.
11. Wilson SS, Fakioglu E, Herold BC. Novel approaches in fighting herpes simplex virus infections. Expert Rev Anti Infect Ther. 2009. 7:559–568.
12. Green LK, Pavan-Langston D. Herpes simplex ocular inflammatory disease. Int Ophthalmol Clin. 2006. 46:27–37.
13. Sado K, Kimura T, Hotta Y, et al. Acute retinal necrosis syndrome associated with herpes simplex keratitis. Retina. 1994. 14:260–263.
14. Solomon MJ. Unilateral acute retinal necrosis syndrome with herpes simplex keratitis. Retina. 1995. 15:359–360.
15. Schlingemann RO, Bruinenberg M, Wertheim-van Dillen P, Feron E. Twenty years' delay of fellow eye involvement in herpes simplex virus type 2-associated bilateral acute retinal necrosis syndrome. Am J Ophthalmol. 1996. 122:891–892.
16. Vandercam T, Hintzen RQ, de Boer JH, Van der Lelij A. Herpetic encephalitis is a risk factor for acute retinal necrosis. Neurology. 2008. 71:1268–1274.
17. Wilhelmus KR. Baum J, Liesegang TJ, editors. Epidemiology of ocular infections. Duane's Foundations of Clinical Ophthalmology. 1998. Vol. 2. Philadelphia: Lippincott Williams & Wilkins;1–46.
18. Thompson WS, Culbertson WW, Smiddy WE, et al. Acute retinal necrosis caused by reactivation of herpes simplex virus type 2. Am J Ophthalmol. 1994. 118:205–211.
19. Atherton SS. Acute retinal necrosis: insights into pathogenesis from the mouse model. Herpes. 2001. 8:69–73.
20. Tran TH, Stanescu D, Caspers-Velu L, et al. Clinical characteristics of acute HSV-2 retinal necrosis. Am J Ophthalmol. 2004. 137:872–879.
21. Clarkson JG, Blumenkranz MS, Culbertson WW, et al. Retinal detachment following the acute retinal necrosis syndrome. Ophthalmology. 1984. 91:1665–1668.
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