1,415 results match your criteria: "Acute Retinal Necrosis"

Purpose: To report a case of exudative retinal detachment (ERD) in a child with Acute retinal necrosis (ARN).

Method: Retrospective Chart Review.

Result: A six-year-old boy presented with anterior uveitis with hypopyon and exudative retinal detachment with peripheral confluent patches of retinitis in the left eye.

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: To report a case of cystoid macular edema (CME) secondary to immune recovery uveitis (IRU) in a patient with previous history of cytomegalovirus (CMV) retinitis and leukemia, which was successfully treated with tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist. : The clinical records of the case were reviewed, focusing on demographics, image findings, and clinical course. : A 17-year-old female with a past medical history of T-cell acute lymphoblastic leukemia (T-ALL) undergoing chemotherapy for two years presented with active CMV retinitis.

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Acute retinal necrosis (ARN) is a serious, sight-threatening condition characterized by rapidly progressive necrotizing retinitis, most commonly caused by varicella-zoster virus and herpes simplex virus. We report an atypical case of ARN in a 57-year-old immunocompetent male, initially misdiagnosed as Vogt-Koyanagi-Harada (VKH) disease. This case highlights the challenges in the early differential diagnosis of infectious and non-infectious uveitis.

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Article Synopsis
  • * Testing revealed the presence of Varicella Zoster Virus (VZV), leading to a diagnosis of acute retinal necrosis (ARN) in both eyes.
  • * After treatment with antiviral medications and steroids, the patient's vision and condition stabilized over three months, highlighting the importance of prompt diagnosis and therapy for ARN.
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Clinical Spectrum and Perspective in Bilateral Acute Retinal Necrosis: Systematic Review.

Medicina (Kaunas)

October 2024

Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University Hospital Polyclinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.

Bilateral acute retinal necrosis (BARN) represents a broad ophthalmological field of severe retinal pathologies associated with poor visual prognosis and blindness. The purpose of this review is to examine the clinical spectrum in detail over the past few years, exploring laboratory and instrumental diagnosis, and providing useful and up-to-date guidance in this field. A systematic review of this field has been performed through the PRISMA guidelines, searching in the PUBMED database.

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To describe the early presentation of successive acute retinal necrosis (ARN) decades after the initial infection. A single case and its findings were analyzed. A 62-year-old man with a remote history of left-sided ARN presented for evaluation of right-sided blurry vision.

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[Viral retinitis].

J Fr Ophtalmol

December 2024

Service d'ophtalmologie, Sorbonne université, CHU Pitié-Salpêtrière, Paris, France.

Viruses belonging to the herpes family group, including HSV (herpes simplex virus) 1 and 2, VZV (varicella zoster virus) and CMV (cytomegalovirus) are the leading causes of necrotizing retinitis. These viral retinal necroses generally manifest in three forms, depending on the patient's immune status: acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN) and CMV retinitis. Although specific, effective drug treatments are available today, early treatment initiation is essential to avoid sight-threatening complications.

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Acute Retinal Necrosis Associated with Epstein-Barr Virus Successfully Treated with Antiviral Treatment: A Case Report.

Microorganisms

October 2024

Department of Ophthalmology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea.

Article Synopsis
  • Epstein-Barr virus (EBV) is a rare but serious cause of acute retinal necrosis (ARN), typically resulting in poor outcomes and limited antiviral treatment options.
  • An 85-year-old man diagnosed with EBV ARN experienced significant visual disturbances and was treated with a combination of intravenous acyclovir and intravitreal ganciclovir.
  • After seven weeks of treatment, the patient's vision improved from 20/200 to 20/100, and the size of the necrotic lesion reduced, suggesting that this combination therapy can be effective for EBV-related ARN.
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Article Synopsis
  • The study aimed to evaluate the safety and effectiveness of dexamethasone implants for treating macular edema (ME) caused by acute retinal necrosis (ARN) in five patients.
  • Results showed that all patients experienced significant relief from ME after the treatment, with no reported recurrences of retinal necrosis or side effects like increased eye pressure.
  • The findings suggest that intravitreal dexamethasone injections can improve visual acuity and effectively manage ME associated with ARN without causing adverse reactions.
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Article Synopsis
  • Cytomegalovirus (CMV) chronic retinal necrosis (CRN) is a rare infection that affects mildly immunocompromised individuals and is treated with ganciclovir, but resistance can develop.
  • An 80-year-old woman with rheumatoid arthritis experienced blurry vision and was diagnosed with retinitis caused by CMV, initially treated with ganciclovir, but later switched to foscarnet and other medications due to resistance.
  • The case highlights the potential increase in CMV CRN cases due to rising use of mild immunosuppressive therapies, and suggests that using combinations like letermovir and leflunomide may be effective alternatives when resistance occurs.
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Acute Retinal Necrosis Caused by Varicella Zoster Virus and Cytomegalovirus Co-Infection.

Ocul Immunol Inflamm

September 2024

Ophthalmology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Article Synopsis
  • The study reports two cases of acute retinal necrosis (ARN) caused by co-infection of varicella zoster virus (VZV) and cytomegalovirus (CMV), confirmed through polymerase chain reaction (PCR) testing on aqueous fluid.
  • Both patients presented with unilateral panuveitis and underwent empirical therapy; PCR results indicated the dual viral infection, which helped tailor their treatment.
  • Follow-up imaging showed resolution of the active retinitis, highlighting the critical role of PCR in diagnosing and managing complicated ARN cases in various patient backgrounds.*
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Risk factors and prognostic factors associated with retinal detachment and visual outcomes in acute retinal necrosis.

BMC Ophthalmol

September 2024

Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.

Objective: To investigate the risk factors and prognostic factors that affect the long-term clinical outcomes of acute retinal necrosis (ARN).

Methods: A retrospective study of patients with ARN who underwent treatment and completed follow-up in our ophthalmology department from 2011 to 2021 was conducted. The incidence and risk factors of retinal detachment (RD) and prognostic factors affecting long-term clinical outcomes, such as late-onset RD and final vision loss (< 20/200), were analyzed.

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Prognostic factors associated with acute retinal necrosis treated non-surgically.

Eye (Lond)

December 2024

Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, PR China.

Article Synopsis
  • The study aimed to identify factors affecting visual acuity in acute retinal necrosis (ARN) patients who were treated without surgery, analyzing clinical data from 2010 to 2023.
  • Among 24 patients, the majority were found to have VZV infection, and over half of the eyes showed improvement in vision following antiviral treatment.
  • Key factors linked to poor visual outcomes included retinal detachment, certain types of necrotizing retinitis, and a high neutrophil to lymphocyte ratio, indicating that initial viral load and inflammation levels are crucial for prognosis.
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Clinical spectrum and possible pathogenesis of progressive outer retinal necrosis.

Br J Ophthalmol

December 2024

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.

Objective: Progressive outer retinal necrosis (PORN) is an alphaherpesvirus-caused panuveitis with devastating consequences for the eye. Our study aims to describe new findings in the clinical spectrum and propose a mechanism for the pathogenesis of PORN.

Methods: Observational, consecutive case series.

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Primary treatment failure in acute retinal necrosis - A comprehensive review.

Indian J Ophthalmol

December 2024

Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India.

Article Synopsis
  • Acute retinal necrosis (ARN) is a severe eye condition that threatens vision and often requires urgent treatment to avoid lasting damage.
  • A study reviewed 35 cases of primary treatment failure (PTF) in ARN, identifying issues like drug resistance and exploring alternative and combination therapies.
  • The review also discusses potential new treatment approaches, including vaccines and monoclonal antibodies, which may offer better future management of ARN.
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Article Synopsis
  • Acute retinal necrosis (ARN) is a serious eye disease that causes inflammation and damage to the retina, making early diagnosis difficult due to often missed peripheral lesions.
  • A case study highlights the successful use of ultrawidefield (UWF) imaging to detect these lesions in a man in his late 60s, who had blurred vision and a history of herpes zoster ophthalmicus.
  • Early detection and antiviral treatment led to significant improvement over a few months, showcasing the importance of UWF imaging in diagnosing and monitoring ARN.
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Article Synopsis
  • This study investigates how the viral load of varicella-zoster virus changes after antiviral treatment in patients suffering from acute retinal necrosis and looks into how different viral genotypes impact clinical symptoms.
  • Researchers analyzed viral loads from the aqueous humor of 20 patients, finding an average initial viral load and identifying a correlation between reaching an inflection point in viral load and the duration of retinitis.
  • They concluded that understanding the viral load curve can help predict retinitis duration, and a specific genetic variation in the virus may be linked to lower initial viral loads, suggesting a potential impact on virulence.
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Refractory acute retinal necrosis presenting as peripapillary choroiditis - A diagnostic and therapeutic challenge.

Indian J Ophthalmol

August 2024

Department of Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India.

This report describes a challenging case of refractory acute retinal necrosis (ARN) with peripapillary choroiditis as the initial presenting sign. Imaging studies confirmed multifocal choroidal lesions and noted the novel sign of vertical hyper-reflective strips (VHRS) in the outer nuclear layer. Initial treatment with acyclovir and valacyclovir failed, and involvement of the other eye suggested a resistant variant of varicella zoster virus.

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Article Synopsis
  • * All patients were initially treated with antiviral medication, but two needed additional surgical intervention due to complications. After the infections were controlled, they developed resistant macular edema, which was treated with a sustained-release dexamethasone implant.
  • * The treatment led to significant improvement in both retinal edema and visual acuity, with no reactivation of the virus or major side effects over a two-year period, suggesting that this implant could be a viable option for similar cases.
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