Acute retinal necrosis syndrome associated with herpes simplex keratitis.
BACKGROUND
Although acute retinal necrosis (ARN) syndrome is caused by a herpes group virus, association of herpetic keratitis with ARN syndrome is uncommon. A case of unilateral ARN syndrome with herpes simplex keratitis is discussed.


METHODS
A 40-year-old man developed unilateral keratitis, necrotic retinitis, retinal vasculitis, vitritis, and iritis consistent with ARN syndrome 1 month after treatment for ipsilateral facial nerve palsy and auricular herpetic vesicles (Tolosa-Hunt syndrome). Impression cytologic examination of the corneal epithelial ulcer that developed concurrent with the intraocular findings and of the aqueous humor (obtained by paracentesis) was performed.


RESULTS
Cells that reacted with anti-herpes simplex virus type 1 (HSV-1) antibody were detected on impression cytology, and DNA fragments corresponding to the HSV-1 DNA sequence were detected in the aqueous humor.


CONCLUSIONS
This case shows that ARN syndrome may, on rare occasions, be associated with herpes keratitis secondary to HSV-1.
Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
K
K
Sado
T
T
Kimura
Y
Y
Hotta
H
H
Sakuma
M
M
Hayakawa
K
K
Kato
A
A
Kanai
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D005158:Facial Paralysis / Q000150:complications / Q000628:therapy; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000276:immunology; D006801:Humans; D016849:Keratitis, Herpetic / Q000150:complications* / Q000175:diagnosis; D008297:Male; D009886:Ophthalmoplegia / Q000150:complications / Q000628:therapy; D015882:Retinal Necrosis Syndrome, Acute / Q000209:etiology* / Q000473:pathology
D000914:Antibodies, Viral; D004279:DNA, Viral