title: Progressive outer retinal necrosis associated with occlusive vasculitis in acquired immunodeficiency syndrome.
abstract: A 45-year-old man, a case of acquired immunodeficiency syndrome, received a highly active antiretroviral therapy at the outpatient service for 4 years without regular follow-up. He experienced progressively blurred vision for 6 months and a cutaneous zoster on his back 3 months ago. He was diagnosed with progressive outer retinal necrosis by polymerase chain reaction-restriction fragment length polymorphism using an aqueous humor sample, which revealed an existence of varicella zoster virus. He was given a combination of systemic, intravitreal antiviral and a highly active antiretroviral therapy. Occlusive vasculitis, an unusual finding for progressive outer retinal necrosis, developed in both eyes 1 week after the secondary intravitreal injection. Unfortunately, his vision deteriorated to no light perception in both eyes within 2 weeks. Progressive outer retinal necrosis is characterized clinically as showing minimal or no inflammation in the aqueous and vitreous humors, absence of retinal vasculitis, and patches of yellowish spots located deep in the retina. Physicians should pay attention to this rare case of progressive outer retinal necrosis associated occlusive vasculitis with very poor prognosis in spite of aggressive treatment.
authors.affiliation: Department of Ophthalmology, Changhua Christian Hospital, Taiwan.
authors.forename: Chien-Chi
authors.initials: CC
authors.lastname: Tseng
authors.affiliation: Department of Ophthalmology, Changhua Christian Hospital, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: San-Ni
authors.initials: SN
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Changhua Christian Hospital, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Jiunn-Feng
authors.initials: JF
authors.lastname: Hwang
authors.affiliation: Department of Ophthalmology, Changhua Christian Hospital, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan. Electronic address: doctoraga@gmail.com.
authors.forename: Chun-Ju
authors.initials: CJ
authors.lastname: Lin
authors.affiliation: An Hsin QingShui Clinic of Fresenius Medical Care Asia Pacific Co Ltd, Taichung, Taiwan.
authors.forename: Huan-Sheng
authors.initials: HS
authors.lastname: Chen
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use*; D001766:Blindness; D018450:Disease Progression; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015882:Retinal Necrosis Syndrome, Acute / Q000188:drug therapy* / Q000821:virology; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D041623:Tomography, Optical Coherence
chemical_list: D000998:Antiviral Agents
keywords: acquired immunodeficiency syndrome; occlusive vasculitis; progressive outer retinal necrosis