title: Progressive outer retinal necrosis combined with vitreous hemorrhage in a patient with acquired immunodeficiency syndrome.
abstract: OBJECTIVE
  To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP).
  
  
  METHODS
  This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP.
  
  
  RESULTS
  The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR.
  
  
  CONCLUSIONS
  PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy.
authors: NUNE Eye Hospital, Seoul, Korea.
authors: Yong Sung
authors: YS
authors: You
authors: Sung Jin
authors: SJ
authors: Lee
authors: Sung Ho
authors: SH
authors: Lee
authors: Chang Hyun
authors: CH
authors: Park
authors: Oh Woong
authors: OW
authors: Kwon
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D018450:Disease Progression; D005260:Female; D006562:Herpes Zoster; D006801:Humans; D009336:Necrosis; D012173:Retinitis / Q000150:complications* / Q000473:pathology / Q000821:virology*; D014823:Vitreous Hemorrhage / Q000150:complications*