title: Delayed onset of bilateral acute retinal necrosis syndrome: a 46-year interval.
abstract: BACKGROUND
  Acute retinal necrosis (ARN) syndrome is an uncommon, severe form of retinitis that is caused by the herpes virus family. Bilateral acute retinal necrosis (BARN) at delayed onset is rare.
  
  
  METHODS
  A retrospective, interventional case is described in a 64-year-old man complaining of blurred vision in the left eye. The patient had a history of presumed ARN in the right eye at the age of 18 years.
  
  
  RESULTS
  The reduced visual acuity and the ocular fundus signs lead us to the diagnosis of delayed-onset BARN. Intravenous and intravitreal antiviral therapy, corticosteroid and antiplatelet treatment were administered until recovering final visual acuity.
  
  
  CONCLUSIONS
  This report represents the longest reported interval of ARN quiescence with eventual bilateral involvement and illustrates the importance of long-term patient follow-up in immunocompetent patients.
authors.affiliation: Diagnostic Chorioretinal Service, Department of Ophthalmology, Sapienza University of Rome , Rome , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: La Cava
authors.forename: Alessandro
authors.initials: A
authors.lastname: Abbouda
authors.forename: Lucia
authors.initials: L
authors.lastname: Restivo
authors.forename: Roberta
authors.initials: R
authors.lastname: Zito
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000235:genetics; D005500:Follow-Up Studies; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007275:Injections, Intravenous; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000000981:diagnostic imaging; D015882:Retinal Necrosis Syndrome, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014786:Vision Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral
keywords: Acyclovir; BARN; foscarnet; herpes virus; intravitreal injection