1/57. HSV-1--induced acute retinal necrosis syndrome presenting with severe inflammatory orbitopathy, proptosis, and optic nerve involvement.OBJECTIVE: To present a unique case in which orbital inflammation, proptosis, and optic neuritis were the initial symptoms of acute retinal necrosis (ARN). The clinical presentation of ARN, as well as the currently recommended diagnostic procedures and guidelines for medical treatment of ARN, are summarized. DESIGN: Interventional case report. TESTING: polymerase chain reaction (PCR) techniques were made on the vitreous for cytomegalovirus, Epstein-Barr virus, herpes simplex virus (HSV), varicella zoster virus, and toxoplasmosis. A full laboratory evaluation was made together with HLA-typing and serologic tests measuring convalescent titers for HSV and other micro-organisms. magnetic resonance imaging scan, computed tomography (CT) scan, and fluorescein angiographic examination were performed. The patient was treated with acyclovir and oral prednisone. MAIN OUTCOME MEASURES: The patient was evaluated for initial and final visual acuity and for degree of proptosis, periocular edema, and vitreitis. RESULTS: The first symptoms and signs of ARN were eye pain, headache, proptosis, and a swollen optic nerve on CT scan. Other than increased c-reactive protein, all blood samples were normal. PCR was positive for HSV-type I in two separate vitreous biopsies. The patient had the strongly ARN-related specificity HLA-DQ7. CONCLUSIONS: This is the first report of HSV-induced ARN presenting with inflammatory orbitopathy and optic neuritis. polymerase chain reaction for HSV-1 was positive more than 4 weeks after debut of symptoms, which is a new finding. The combination of severe vitreitis and retinal whitening, with or without proptosis, should alert the clinician to the possibility of herpes infection and treatment with intravenous acyclovir started promptly.- - - - - - - - - - ranking = 1keywords = herpes simplex, simplex, herpes, ocular (Clic here for more details about this article) |
2/57. Progressive outer retinal necrosis caused by herpes simplex virus type 1 in a patient with acquired immunodeficiency syndrome.OBJECTIVE/BACKGROUND: To identify the etiologic agent of rapidly progressive outer retinal necrosis (PORN) in a 32-year-old man with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from cytomegalovirus (CMV). Multiple yellowish spots appeared in the deep retina without evidence of intraocular inflammation or retinal vasculitis, diagnosed clinically as PORN. death occurred after failure of multiple organs. DESIGN: Case report. methods: Both globes were taken at autopsy, fixed in formalin, and examined histopathologically and immunohistochemically to identify causative agents in the retinal lesions. MAIN OUTCOME MEASURE: immunohistochemistry. RESULTS: All layers of the retina were severely damaged and contained focal calcification. Cytomegalic inclusion bodies were found in cells in the damaged retina of the right eye. Immunohistochemical studies for herpesviruses revealed the presence of CMV antigens in the right retina at the posterior pole and herpes simplex virus type 1 (HSV-1)-specific antigen in the periphery of both retinas. No varicella-zoster virus (VZV) antigen was detected in either retina. 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, HSV-1 can be an etiologic agent.- - - - - - - - - - ranking = 4.7254463296572keywords = herpes simplex, simplex, herpes, ocular (Clic here for more details about this article) |
3/57. Acute retinal necrosis following contralateral herpes zoster ophthalmicus.BACKGROUND: A case report of contralateral acute retinal necrosis (ARN) following herpes zoster ophthalmicus. CASE: A 61-year-old male patient developed iridocyclitis and well-demarcated creamy-white retinal lesions at the nasal periphery in the right eye 1 month after herpes zoster ophthalmicus in the left eye. The patient had undergone surgery for primary lung cancer, and had subsequent intracranial metastasis of the tumor. OBSERVATIONS: The clinical diagnosis of ARN was supported by polymerase chain reaction investigation of the aqueous humor resulting in positive for varicella-zoster virus. Retinal lesions disappeared after systemic treatment with acyclovir, corticosteroids, and acetylsalicylate. No retinal detachment developed. CONCLUSIONS: We propose a careful ophthalmic follow-up for herpes zoster ophthalmicus patients because of the possibility of acute retinal necrosis developing in the contralateral eye.- - - - - - - - - - ranking = 0.47664935798131keywords = herpes (Clic here for more details about this article) |
4/57. Sight-threatening varicella zoster virus infection after fludarabine treatment.Varicella zoster virus (VZV) infection involving the posterior segment of the eye after fludarabine treatment has not previously been described. Two patients, who had completed fludarabine treatment 3 and 18 months previously, presented with visual loss that had been preceded by a recent history of cutaneous zoster. The use of the polymerase chain reaction (PCR) for VZV dna from ocular specimens allowed rapid confirmation of clinical diagnosis and treatment with a good outcome in one patient. With the increasing use of fludarabine and other purine analogues, an awareness of such complications is important because of their potentially sight-threatening consequences.- - - - - - - - - - ranking = 0.00054565215978613keywords = ocular (Clic here for more details about this article) |
5/57. herpes simplex virus dna in the lens one year after an episode of retinitis.The present report describes a case where HSV was detected by polymerase chain reaction (PCR) in the lens cortical material removed during cataract surgery one year after resolution of retinal inflammation in a patient with ARN.- - - - - - - - - - ranking = 0.51764377168196keywords = simplex (Clic here for more details about this article) |
6/57. Acute retinal necrosis syndrome complicating chickenpox.chickenpox may be complicated by ocular involvement. In these patents, acute retinal necrosis usually forms a relatively mild course. Systemic antiviral treatment during the acute phase of the disease is recommended. Rarely, retinal detachment may develop, resulting in blindness. It is strongly recommended that patients with chickenpox who develop visual symptoms should be referred for an ophthalmological opinion early.- - - - - - - - - - ranking = 0.00054565215978613keywords = ocular (Clic here for more details about this article) |
7/57. Presumed acquired ocular toxoplasmosis in deer hunters.PURPOSE: To describe acquired ocular toxoplasmosis in deer hunters. methods AND RESULTS: The authors describe five young men presenting with flu-like symptoms followed by visual loss due to a unilateral, focal necrotizing retinitis. All five men gave a history of ingesting undercooked or uncooked venison. All five had elevated toxoplasma serology, and all five improved clinically with an antitoxoplasma regimen. CONCLUSION: In previously healthy young men, flu-like symptoms associated with visual loss and retinitis should prompt questioning about hunting and raw game meat ingestion, especially when toxoplasmosis is suspected.- - - - - - - - - - ranking = 0.0027282607989307keywords = ocular (Clic here for more details about this article) |
8/57. herpes simplex virus type 2: a cause of acute retinal necrosis syndrome.PURPOSE: To describe a case of herpes simplex virus type 2 (HSV-2) acute retinal necrosis syndrome (ARN) in a 13-year-old immunocompetent girl. methods: polymerase chain reaction (PCR), cultures, flow cytometry, and cytology were performed on the vitreous sample. RESULTS: Both PCR studies and vitreous cultures revealed HSV-2 as the cause of ARN. flow cytometry showed CD4 , CD8 , and natural killer cells. The visual outcome of the patient was 20/200. CONCLUSION: Successful culture of HSV-2 from the vitreous specimen in a patient with ARN proved HSV-2 to be one of the causes of ARN. The successful culture of HSV-2 has not been previously reported.- - - - - - - - - - ranking = 1.4490053540963keywords = herpes simplex, simplex, herpes (Clic here for more details about this article) |
9/57. Findings in a patient with herpes simplex viral meningitis associated with acute retinal necrosis syndrome.We report the case of a 41-year-old man with clinical findings of viral meningitis associated with acute retinal necrosis syndrome in his right eye. MR images showed right optic nerve enlargement and high-intensity signal abnormalities in the region of the left lateral geniculate body and the left occipital lobe.- - - - - - - - - - ranking = 3.7254463296572keywords = herpes simplex, simplex, herpes (Clic here for more details about this article) |
10/57. Acute retinal necrosis in children caused by herpes simplex virus.PURPOSE: To report the diagnosis, management, and outcome of acute retinal necrosis syndrome in children. METHOD: Case series of three consecutive children aged 11 years and younger who were diagnosed with acute retinal necrosis. In addition to full ocular and systemic examinations, the children underwent vitreous biopsy (patients 1 and 2) or aqueous tap (Patient 3) for polymerase chain reaction analysis. RESULTS: All patients had unilateral retinitis that was associated with preexisting chorioretinal scars, and two patients (patients 1 and 3) had concurrent extraocular central nervous system abnormalities. Intraocular herpes simplex virus was detected in all three children: Type 1 in Patient 1 and Type 2 in patients 2 and 3. In addition, all three children had a history of extraocular herpes simplex virus infection. CONCLUSIONS: retinitis associated with preexisting chorioretinal scars and detectable intraocular herpes simplex virus on polymerase chain reaction was common to all three children with acute retinal necrosis.- - - - - - - - - - ranking = 6.5222593376991keywords = herpes simplex, simplex, herpes, ocular (Clic here for more details about this article) |
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