RESUMEN
PURPOSE: To describe a case of retinal perivasculitis in an immunocompetent patient with systemic herpes simplex infection. METHODS: Polymerase chain reaction amplifications were performed for aqueous and blood samples using primers specific for the following members of the herpesvirus family: cytomegalovirus, Epstein-Barr virus, herpes simplex virus (types 1 and 2), and varicella-zoster virus. The patient was placed on intravenous acyclovir and systemic corticosteroids. RESULTS: A positive polymerase chain reaction signal was found only for herpes simplex virus type 1. Vision in the left eye improved from light perception to 20/25, and signs of retinal perivasculitis resolved. CONCLUSION: The use of molecular diagnostic modalities in clinical practice may aid in determining infectious etiologies in patients with atypical clinical manifestations.
Asunto(s)
Infecciones Virales del Ojo/diagnóstico , Herpes Simple/diagnóstico , Inmunocompetencia , Vena Retiniana/patología , Retinitis/diagnóstico , Vasculitis/diagnóstico , Aciclovir/uso terapéutico , Antivirales/uso terapéutico , Humor Acuoso/virología , ADN Viral/análisis , Infecciones Virales del Ojo/tratamiento farmacológico , Infecciones Virales del Ojo/etiología , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Herpes Simple/tratamiento farmacológico , Herpes Simple/etiología , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/aislamiento & purificación , Humanos , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Retinitis/tratamiento farmacológico , Retinitis/virología , Vasculitis/tratamiento farmacológico , Vasculitis/virología , Viremia/virologíaRESUMEN
OBJECTIVE: To establish a new model of exudative retinal detachment in the rat. METHODS: Photothrombosis was produced in a single retinal vein using direct treatment with a dye laser operating in the yellow wavelength (577 nm). Control eyes received identical laser applications, but treatment was placed alongside the vessel and photothrombosis was not produced. Eyes were examined at intervals during the subsequent week with ophthalmoscopy, photography, fluorescein angiography, and light microscopy. RESULTS: In 13 (41%) of 32 eyes with photothrombosis, bullous retinal detachments developed 1 day after laser treatment, and continued occlusion of the vein was confirmed with fluorescein angiography. Detachments persisted for 2 to 4 days and spontaneously resolved; resolution coincided with restored venous patency at 5 to 7 days. None of the 20 control eyes developed bullous detachments (P < .005). CONCLUSIONS: Laser photothrombosis in the rat offers a simple and accessible model of transient exudative retinal detachment without the need for exogenous chromophores.