Progressive Outer Retinal Necrosis Combined with Vitreous Hemorrhage in a Patient with Acquired Immunodeficiency Syndrome.
- Author:
Yong Sung YOU
1
;
Sung Jin LEE
;
Sung Ho LEE
;
Chang Hyun PARK
;
Oh Woong KWON
Author Information
- Publication Type:Case Report
- Keywords: AIDS; CMV; HSV; PORN; VZV
- MeSH: Vitreous Hemorrhage/*complications; Retinitis/*complications/pathology/*virology; Necrosis; Humans; *Herpes Zoster; Female; Disease Progression; Adult; Acquired Immunodeficiency Syndrome/*complications
- From:Korean Journal of Ophthalmology 2007;21(1):51-54
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). METHODS: This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP. RESULTS: The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy.
