A Case of Acute Retinal Necrosis in Healthy Childhood

Byoung Seon Kim; Ji Hye Kim; Yong Seop Han; In Young Chung; Jong Moon Park

doi:10.3341/jkos.2016.57.1.125

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Kim, Kim, Han, Chung, and Park: A Case of Acute Retinal Necrosis in Healthy Childhood

Original Article

J Korean Ophthalmol Soc 2016;57(1):125-129.

Published online: 31 August 2016

DOI: https://doi.org/10.3341/jkos.2016.57.1.125

A Case of Acute Retinal Necrosis in Healthy Childhood

Byoung Seon Kim, M.D¹, Ji Hye Kim, M.D¹, Yong Seop Han, M.D, PhD^1,², In Young Chung, M.D, PhD^1,², Jong Moon Park, M.D, PhD^1,^2,

¹Department of Ophthalmology, Gyeongsang National University School of Medicine^¹, Jinju, Korea

²Institute of Health Science, Gyeongsang National University, Jinju, Korea

Address reprint requests to Jong Moon Park, MD, PhD Department of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 52727, Korea Tel: 82-55-750-8167, Fax: 82-55-758-4158 E-mail: parkjm@gnu.ac.kr

Received 10 April 201513 August 2015 Accepted 25 September 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

To describe a case of acute retinal necrosis (ARN) in childhood.

Case summary

A 6-year-old child visited our clinic complaining of conjunctival injection and decreased visual acuity in the left eye. Slit-lamp examination showed conjunctival injection, inflammatory cells (4+) in the anterior chamber, and keratic precipitates. Fundus examination showed disc swelling. The patient was treated with 30 mg of oral prednisolone and 1% pre-dnisolone acetate with the suspicion of uveitis. After 2 days, retinal examination showed a peripheral multifocal yellowish patch and retinal hemorrhage. Herpes simplex virus-2 was detected using polymerase chain reaction (PCR) analysis of the aqueous humor, which was obtained by anterior chamber paracentesis. In the present case, ARN in childhood was successfully treated with intravenous acyclovir.

Conclusions:

We report a case of ARN in childhood diagnosed using PCR. Intravenous acyclovir may be an effective therapy in children with ARN. Ophthalmologists should promptly perform PCR analysis in patients diagnosed with ARN.

Keywords: Acute retinal necrosis, Herpes simplex virus, Polymerase chain reaction

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Figure 1.

Anterior segment and Fundus photograph at the first visit. (A) In initial presentations, slit-lamp examination shows con-junctival injection, inflammatory cell (4+) in the anterior chamber and keratic precipitates. (B) Fundus photographs shows disc swelling.

Figure 2.

Fundus photographs at the 2 days later. It shows disc swelling, peripheral multifocal yellowish patch and retinal hemorrhage.

Figure 3.

After a sample of aqueous humor was obtained by anterior chamber paracentesis, PCR analysis was performed. The analysis detected HSV-2. PCR = polymerase chain re-action; HSV = herpes simplex virus.

Figure 4.

Fundus photograph after treatment of intravenous acyclovir. (A) After 14 days, disc swelling, peripheral multifocal yel-lowish patch, and retinal hemorrhage decrease. (B) After 2 months, disc swelling, necrotic change was decrease.

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