Varicella zoster virus acute retinal necrosis following eye contusion: case report.
BACKGROUND
Acute retinal necrosis is a sight-threatening disease caused by the group of herpesviruses. The aim of this paper is to report a case of acute retinal necrosis following ocular trauma in a patient initially treated with vaso-active drugs and corticosteroids for presumed ocular ischemic syndrome.


METHODS
A 51-years-old otherwise healthy man, who suffered from sudden visual loss in the left eye following contusion, was commenced on vaso-active drugs and systemic corticosteroids for suspected ocular ischemic syndrome with extensive swelling of the optic disc and macular edema. Subsequently, vision in the initially uninvolved right eye decreased. Polymerase chain reaction of vitreous samples and retinal biopsy confirmed varicella zoster virus. Despite intensive treatment with intravenous antiviral medication, the patient became completely blind in both eyes.


CONCLUSIONS
Initial treatment of acute, unexplained visual decrease with systemic corticosteroids may lead to visual loss in patients with developing acute retinal necrosis. Ocular trauma could have induced and corticosteroid treatment promoted reactivation of a latent viral infection in our patient.
Svozílková
Petra
P
Department of Ophthalmology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. psvoz@lf1.cuni.cz
Ríhová
Eva
E
Diblík
Pavel
P
Kuthan
Pavel
P
Kovarík
Zdenek
Z
Kalvodová
Bohdana
B
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D003288:Contusions / Q000150:complications*; D005131:Eye Injuries / Q000150:complications*; D006562:Herpes Zoster / Q000175:diagnosis* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015882:Retinal Necrosis Syndrome, Acute / Q000821:virology*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D017735:Virus Latency
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D014662:Vasoconstrictor Agents