Progressive outer retinal necrosis syndrome in a lymphoma patient with good visual outcome.
OBJECTIVE
To report an HIV-negative lymphoma patient who developed progressive outer retinal necrosis syndrome and who had a good visual outcome after treatment with two-drug antiviral therapy and intravenous immunoglobulin.


METHODS
Case report.


RESULTS
A 43-year-old man with small lymphocytic lymphoma was diagnosed with progressive outer retinal necrosis in his left eye. Treatment was initiated with intravenous foscarnet and ganciclovir as well as intravenous gammaglobulin at a dose of 0.5 gm/kg per day for 5 days. On the second hospital day he was started on decadron 4 mg orally four times daily. No further posterior retinitis progression was observed despite severe immunosuppression. Visual acuity remained stable at 20/30 with 10 months' follow-up.


CONCLUSIONS
The benefit of using gammaglobulin in progressive outer retinal necrosis is unknown. Given the rapid improvement seen in this patient's retinitis, it may be reasonable to consider the use of gammaglobulin in other cases of infectious retinitis in immunocompromised patients.
Foster
R E
RE
Cincinnati Eye Institute, Cincinnati, Ohio 45242, USA. refcei@cintieye.com
Petersen
M R
MR
Neuss
M N
MN
Osher
R H
RH
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008297:Male; D015882:Retinal Necrosis Syndrome, Acute / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014792:Visual Acuity
D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D017245:Foscarnet; D015774:Ganciclovir