Four cases of bilateral acute retinal necrosis with a long interval after the initial onset.
OBJECTIVE
To report the clinical features and causative virus of bilateral acute retinal necrosis (BARN) with a long interval after the initial onset.


METHODS
The causative virus and clinical features were retrospectively investigated in four patients with delayed-onset BARN with an interval of more than 3 years after the onset of the disease in the initially affected eye.


RESULTS
The intervals between the initially affected eye and the latter affected eye of the four cases were 8 years 7 months, 19 years 3 months, 9 years 7 months and 3 years 6 months. The fourth patient developed a second recurrence in the latter affected eye 17 years 6 months after the initial inflammation in the fellow eye. In all four cases, the same virus species, either varicella-zoster virus or herpes simplex virus, was detected in both eyes by PCR or antibody detection. In all cases, the final best-corrected visual acuity of the latter affected eye (20/20, 18/20, 20/20 and 12/20, respectively) was better than that of the initially affected eye (20 cm hand motion, light perception-negative, light perception-negative and light perception-positive, respectively).


CONCLUSIONS
The present findings indicate that delayed-onset BARN in the fellow eye was caused by the same herpes virus species that induced the disease in the first affected eye.
Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo 160-0023, Japan. yoko-okunuki@nifty.com
Yoko
Y
Okunuki
Yoshihiko
Y
Usui
Takeshi
T
Kezuka
Masaru
M
Takeuchi
Hiroshi
H
Goto
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001082:Aqueous Humor / Q000821:virology; D002648:Child; D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015882:Retinal Necrosis Syndrome, Acute / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D018139:Simplexvirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D013997:Time Factors; D014792:Visual Acuity; D014822:Vitreous Body / Q000821:virology
D000914:Antibodies, Viral; D004279:DNA, Viral