RESUMO
PURPOSE: To report clinical features of acute retinal necrosis (ARN) using optical coherence tomography angiography. METHODS: A 59-year-old female patient presented with blurred vision in the left eye for 1 day. The patient presented posterior uveitis with multiple peripheral areas of retinal pallor with presumed acute retinal necrosis. Herpes simplex virus Type 1 infection was confirmed after serologic tests, and the polymerase chain reaction analysis of the aqueous humor tested positive. RESULTS: The left eye examination revealed anterior chamber reaction, mild vitritis, optic disk swelling, and yellowish white retinal lesions with discrete borders along the superotemporal arcade and temporal periphery. Baseline optical coherence tomography angiography revealed decreased vascular density of superficial and deep plexuses of superotemporal macular region. One month after oral valacyclovir 2,000 mg twice daily, visual acuity and retinal lesions improved, and optical coherence tomography angiography images showed improvement of vascular density. CONCLUSION: Occlusive arterial vasculopathy is one of the main clinical characteristics of acute retinal necrosis. We herein describe for the first time the features of retinal vasculature in acute retinal necrosis revealed by optical coherence tomography angiography, showing decreased vascular density of superficial and deep plexuses.
Assuntos
Infecções Oculares Virais/diagnóstico , Herpes Simples/diagnóstico , Herpesvirus Humano 1/isolamento & purificação , Síndrome de Necrose Retiniana Aguda/diagnóstico , Vasos Retinianos/patologia , Antivirais/uso terapêutico , Humor Aquoso/virologia , Infecções Oculares Virais/tratamento farmacológico , Infecções Oculares Virais/virologia , Feminino , Angiofluoresceinografia , Herpes Simples/tratamento farmacológico , Herpes Simples/virologia , Humanos , Pessoa de Meia-Idade , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologia , Microscopia com Lâmpada de Fenda , Tomografia de Coerência Óptica , Valaciclovir/uso terapêutico , Acuidade Visual/fisiologiaRESUMO
Acute retinal necrosis (ARN) is a serious condition that can impair vision. It mostly occurs in adult patients, especially those severely immunocompromised, in association with a reactivation of a herpes virus infection. We present a 4 years old patient with high risk acute leukemia, whom during a course of intense chemotherapy acquired chickenpox with visceral involvement that affected the retina, causing unilateral blindness. Varicella-zoster virus was detected by PCR in the vitreous humor, in spite of previous acyclovir treatment. The contralateral vision remained undamaged.
Assuntos
Varicela/complicações , Hospedeiro Imunocomprometido , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologia , Antivirais/uso terapêutico , Varicela/diagnóstico , Varicela/tratamento farmacológico , Pré-Escolar , Humanos , Masculino , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológicoRESUMO
Acute retinal necrosis (ARN) is a serious condition that can impair vision. It mostly occurs in adult patients, especially those severely immunocompromised, in association with a reactivation of a herpes virus infection. Clinical and ophtalmological features of ARN and recommended diagnostic and management strategies are reviewed.
Assuntos
Síndrome de Necrose Retiniana Aguda , Adulto , Antivirais/uso terapêutico , Criança , Diagnóstico Diferencial , Humanos , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologiaRESUMO
La necrosis retinal aguda (NRA) es una afección grave que amenaza la visión. Se describe en adultos, en especial aquellos profundamente inmunocompro-metidos, como consecuencia de la reactivación de virus del grupo herpes. Presentamos un paciente de 4 años de edad, con una leucemia de alto riesgo, que durante una quimioterapia intensa desarrolló una varicela con compromiso visceral, incluyendo la retina, lo que le causó ceguera unilateral. En el humor vitreo se detectó ADN de virus varicela-zoster, pese al tratamiento con aciclovir. La visión del ojo contralateral permaneció indemne.
Acute retinal necrosis (ARN) is a serious condition that can impair vision. It mostly occurs in adult patients, especially those severely immunocompromised, in association with a reactivation of a herpes virus infection. We present a 4 years old patient with high risk acute leukemia, whom during a course of intense chemotherapy acquired chickenpox with visceral involvement that affected the retina, causing unilateral blindness. Varicella-zoster virus was detected by PCR in the vitreous humor, in spite of previous acyclovir treatment. The contralateral vision remained undamaged.
Assuntos
Pré-Escolar , Humanos , Masculino , Varicela/complicações , Hospedeiro Imunocomprometido , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologia , Antivirais/uso terapêutico , Varicela/diagnóstico , Varicela/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológicoRESUMO
La necrosis retinal aguda (NRA) es una afección grave que amenaza la visión. Se presenta en adultos, en especial aquellos profundamente inmunocompro-metidos, como consecuencia de la reactivación de virus del grupo herpes. Se revisan la entidad clínica de la NRA, su diagnóstico nosológico y etiológico, como el manejo recomendado actualmente.
Acute retinal necrosis (ARN) is a serious condition that can impair vision. It mostly occurs in adult patients, especially those severely immunocompromised, in association with a reactivation of a herpes virus infection. Clinical and ophtalmological features of ARN and recommended diagnostic and management strategies are reviewed.
Assuntos
Adulto , Criança , Humanos , Síndrome de Necrose Retiniana Aguda , Antivirais/uso terapêutico , Diagnóstico Diferencial , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologiaRESUMO
Many cases of acute retinal necrosis caused by HSV-2 have been reported in children, teenagers, and young adults as a result of reactivation of congenital or neonatal infections, which may have been subclinical. Pediatricians should be aware of this entity and alert to recurrences that may be delayed by years.