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Current Molecular Medicine

Editor-in-Chief

ISSN (Print): 1566-5240
ISSN (Online): 1875-5666

Case Report

Clinical Features of Acute Retinal Necrosis with Optic Neuropathy and Central Retinal Artery Occlusion as Initial Manifestations

Author(s): Bainan Tong, Li Yang, Feng Bai, Yan Jia and Xiaoli Liu*

Volume 22, Issue 8, 2022

Published on: 11 January, 2022

Page: [717 - 721] Pages: 5

DOI: 10.2174/1566524021666211104110344

Price: $65

Abstract

Acute retinal necrosis normally occurs at the periphery retina and gradually merges and progresses to the posterior pole. Optic neuropathy and central retinal artery occlusion as initial manifestation is very rare. We report the case of a patient with optic neuropathy and central retinal vessels as the first manifestations of acute retinal necrosis. Antiviral drugs, corticosteroids, and drugs that improve blood circulation were given. The necrotic retina and swollen optic disc disappeared gradually. However, the final vision of this eye declined to no light perception. From the first case report in 2001 to now, a total of 8 sporadic cases have been reported. The average onset age is 60.85±14.05 years. Most of them had no history of virus infection. Cardiovascular disease history maybe a risk factor. Acute retinal necrosis should be considered in patients with retinal vascular occlusion accompanied by granulomatous anterior uveitis. Further research is needed to determine whether treatments in addition to antiviral and corticosteroid therapy are needed.

Keywords: Acute retinal necrosis, optic neuropathy, central retinal artery occlusion, virus, uveitis, UZV, cardiovascular disease.

[1]
Holland GN, Cornell PJ, Park MS, et al. An association between acute retinal necrosis syndrome and HLA-DQw7 and phenotype Bw62, DR4. Am J Ophthalmol 1989; 108(4): 370-4.
[http://dx.doi.org/10.1016/S0002-9394(14)73303-3] [PMID: 2801857]
[2]
Kezuka T, Sakai J, Usui N, Streilein JW, Usui M. Evidence for antigen-specific immune deviation in patients with acute retinal necrosis. Arch Ophthalmol 2001; 119(7): 1044-9.
[http://dx.doi.org/10.1001/archopht.119.7.1044] [PMID: 11448326]
[3]
Culbertson WW, Blumenkranz MS, Haines H, Gass DM, Mitchell KB, Norton EW. The acute retinal necrosis syndrome. Part 2: Histopathology and etiology. Ophthalmology 1982; 89(12): 1317-25.
[http://dx.doi.org/10.1016/S0161-6420(82)34638-2] [PMID: 6298683]
[4]
Labetoulle M, Offret H, Haut J, Bloch-Michel E, Ullern M, Monin C. Acute retinal necrosis syndrome. Retrospective study apropos of 14 eyes in 11 patients. J Fr Ophtalmol 1995; 18(12): 777-87.
[PMID: 8745711]
[5]
Kang SW, Kim SK. Optic neuropathy and central retinal vascular obstruction as initial manifestations of acute retinal necrosis. Jpn J Ophthalmol 2001; 45(4): 425-8.
[http://dx.doi.org/10.1016/S0021-5155(01)00336-7] [PMID: 11485778]
[6]
Witmer MT, Pavan PR, Fouraker BD, Levy-Clarke GA. Acute retinal necrosis associated optic neuropathy. Acta Ophthalmol 2011; 89(7): 599-607.
[http://dx.doi.org/10.1111/j.1755-3768.2010.01911.x] [PMID: 20645925]
[7]
Agarwal M, Gupta C, Jain A, Kumar B. Branch retinal artery occlusion as a presenting sign of acute retinal necrosis: a rare association. J Ophthalmic Inflamm Infect 2020; 10(1): 8.
[http://dx.doi.org/10.1186/s12348-020-0199-2] [PMID: 32052206]
[8]
Kojima M, Kimura H, Yodoi Y, Matsunaga N, Ogura Y. Preceding of optic nerve involvement in acute retinal necrosis. Retina 2004; 24(2): 297-9.
[http://dx.doi.org/10.1097/00006982-200404000-00017] [PMID: 15097893]
[9]
Schoenberger SD, Kim SJ, Thorne JE, et al. Diagnosis and treatment of acute retinal necrosis: a report by the american academy of ophthalmology. Ophthalmology 2017; 124(3): 382-92.
[http://dx.doi.org/10.1016/j.ophtha.2016.11.007] [PMID: 28094044]
[10]
Stryjewski TP, Scott NL, Barshak MB, et al. Treatment of refractory acute retinal necrosis with intravenous foscarnet or cidofovir. Ocul Immunol Inflamm 2018; 26(2): 199-203.
[http://dx.doi.org/10.1080/09273948.2016.1207788] [PMID: 27598973]
[11]
Yeh S, Fahle G, Flaxel CJ, Francis PJ. Central retinal vascular occlusion associated with acute retinal necrosis. Arch Ophthalmol 2012; 130(4): 514-7.
[http://dx.doi.org/10.1001/archophthalmol.2011.1735] [PMID: 22491922]
[12]
Kahloun R, Mbarek S, Khairallah-Ksiaa I, Jelliti B, Yahia SB, Khairallah M. Branch retinal artery occlusion associated with posterior uveitis. J Ophthalmic Inflamm Infect 2013; 3(1): 16-6.
[http://dx.doi.org/10.1186/1869-5760-3-16] [PMID: 23514435]
[13]
Tajunisah I, Reddy SC, Tan LH. Acute retinal necrosis by cytomegalovirus in an immunocompetent adult: case report and review of the literature. Int Ophthalmol 2009; 29(2): 85-90.
[http://dx.doi.org/10.1007/s10792-007-9171-5] [PMID: 18026692]
[14]
Shantha JG, Weissman HM, Debiec MR, Albini TA, Yeh S. Advances in the management of acute retinal necrosis. Int Ophthalmol Clin 2015; 55(3): 1-13.
[http://dx.doi.org/10.1097/IIO.0000000000000077] [PMID: 26035758]
[15]
Egwuagu CE, Sun L, Kim SH, Dambuza IM. Ocular inflammatory diseases: molecular pathogenesis and immunotherapy. Curr Mol Med 2015; 15(6): 517-28.
[http://dx.doi.org/10.2174/1566524015666150731095426] [PMID: 26238372]
[16]
Weissman HM, Biousse V, Schechter MC, Del Rio C, Yeh S. Bilateral central retinal artery occlusion associated with herpes simplex virus-associated acute retinal necrosis and meningitis: case report and literature review. Ophthalmic Surg Lasers Imaging Retina 2015; 46(2): 279-83.
[http://dx.doi.org/10.3928/23258160-20150213-24] [PMID: 25707059]

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