30 October 2014 : Original article
Clinical Manifestation of Self-Limiting Acute Retinal Necrosis
Joanna Brydak-GodowskaABCDEF, Piotr BorkowskiBDEF, Szymon SzczepanikBDE, Joanna Moneta-WielgośCDF, Dariusz KęcikEGDOI: 10.12659/MSM.890469
Med Sci Monit 2014; 20:2088-2096
Abstract
BACKGROUND: The purpose of this paper was to present a case series of self-limiting, peripheral acute retinal necrosis and to demonstrate efficacy of treatment with valacyclovir in patients resistant to acyclovir. The diagnosis was made on ophthalmoscopic examination and positive serum tests for herpes viruses.
MATERIAL AND METHODS: Ten patients (6F and 4M) aged 19–55 years were diagnosed and treated for self-limiting acute retinal necrosis (ARN). The following endpoints were reported: visual outcomes, clinical features, disease progression, treatment, and complications. Patients received only symptomatic treatment because they did not consent to vitreous puncture.
RESULTS: Peripheral, mild retinitis was diagnosed in all eyes at baseline. Initially, all patients were treated with systemic acyclovir (800 mg, 5 times a day), prednisone (typically 40–60 mg/day), and aspirin in an outpatient setting. In 6 patients, treatment was discontinued at 6 months due to complete resolution of the inflammatory process. Four patients with immune deficiency showed signs and symptoms of chronic inflammation. Two patients did not respond to acyclovir (2 non-responders); however, those patients were successfully treated with valacyclovir. Complete resolution of inflammatory lesions was observed in 8 patients. In 2 patients, the disease progressed despite treatment – 1 female patient after kidney transplant who stopped the prescribed medications, and 1 male patient with SLE and antiphospholipid syndrome who experienced breakthrough symptoms on-treatment. He died due to cerebral venous sinus thrombosis. Neurological complications (encephalitis and meningitis) were observed in 2 female patients. Prophylactic laser photocoagulation was performed in 1 subject.
CONCLUSIONS: A series of cases of self-limiting acute retinal necrosis (ARN) is presented. This clinical form of ARN can resemble toxoplasmic retinitis in some cases. Oral antiviral medications provide an effective alternative to intravenous formulations in patients with self-limiting ARN. Retinitis is associated with the risk of encephalitis.
Keywords: Aspirin - therapeutic use, Antiviral Agents - therapeutic use, Acyclovir - therapeutic use, Prednisone - therapeutic use, Retinal Necrosis Syndrome, Acute - pathology, Valine - therapeutic use, young adult
Editorial
01 April 2025 : Editorial
Editorial: Rapid Testing for the Avian Influenza A(H5N1) Virus is Urgently Required as Infections in Poultry and Dairy Cows are on the Rise, and so is Transmission to HumansDOI: 10.12659/MSM.949109
Med Sci Monit 2025; 31:e949109
In Press
Clinical Research
Serum Prolidase and Ischemia-Modified Albumin Levels in Neural Tube Defects: A Comparative Study of Myelome...Med Sci Monit In Press; DOI: 10.12659/MSM.947873
Clinical Research
Impact of Depression, Fatigue, and Pain on Quality of Life in Slovak Multiple Sclerosis PatientsMed Sci Monit In Press; DOI: 10.12659/MSM.947630
Clinical Research
Longitudinal Evaluation of Metabolic Benefits of Inactivated COVID-19 Vaccination in Diabetic Patients in T...Med Sci Monit In Press; DOI: 10.12659/MSM.947450
Clinical Research
Impact of Voltage Level on Hospitalization and Mortality in Electrical Injury Cases: A Retrospective Analys...Med Sci Monit In Press; DOI: 10.12659/MSM.947675
Most Viewed Current Articles
17 Jan 2024 : Review article 8,000,435
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research 702,963
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Mar 2024 : Editorial 30,040
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and ...DOI :10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
28 Jan 2024 : Review article 23,978
A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and FutureDOI :10.12659/MSM.943912
Med Sci Monit 2024; 30:e943912