Varicella-zoster virus retinitis: successful evolution with a combination of antiviral therapies.
BACKGROUND
We present the description of a successful outcome in a case of varicella-zoster virus (VZV) acute retinal necrosis (ARN).


METHODS
A healthy 40-year-old patient was admitted for a VZV retinitis.


RESULTS
10 days after the onset of intravenous (i. v.) acyclovir treatment, new small peripheral retinal necrotic lesions appeared in the right eye. A viral resistance was suspected and the acyclovir therapy was optimised with i. v. foscarnet combined with 2 intravitreal injections of ganciclovir. The outcome was favourable with a final vision of 1.0 after a follow-up of 30 months. No systemic or local complications were observed.


CONCLUSIONS
VZV ARN is a severe infection with a poor prognosis. This case demonstrates that combination of antiviral therapies given intravenously (acyclovir + foscarnet) and in the vitreous (ganciclovir) may be safe and efficacious in the management of necrotising herpetic retinopathies affecting immunocompetent patients.
Oueghlani
E
E
Clinique d'Ophtalmologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
Baglivo
E
E
Durakovic
O
O
Safran
A B
AB
D000212:Acyclovir / Q000008:administration & dosage*; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D006562:Herpes Zoster / Q000188:drug therapy*; D014645:Herpesvirus 3, Human; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009887:Ophthalmoscopy; D015882:Retinal Necrosis Syndrome, Acute / Q000175:diagnosis / Q000188:drug therapy*; D014786:Vision Disorders / Q000209:etiology
D000998:Antiviral Agents; D000212:Acyclovir