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Year : 2021  |  Volume : 3  |  Issue : 1  |  Page : 24

Simultaneous amplification of herpes simplex virus type 2 and Epstein–Barr virus in an immunocompetent host with acute retinal necrosis

Department of Ophthalmology, School of Medicine and Health Sciences, Tecnologico de Monterrey, Monterrey, Mexico

Correspondence Address:
Dr. Carlos Alvarez-Guzman
School of Medicine and Health Science, Tecnologico de Monterrey, Av. Ignacio Morones Prieto 3000, Colonia Los Doctores, CP 64710, Monterrey, Nuevo León
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pajo.pajo_99_21

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Acute retinal necrosis (ARN) is an ocular inflammatory disease characterized by panuveitis and retinal vasculitis. Herpes virus is strongly associated with ARN and can often be detected by polymerase chain reaction (PCR) of vitreous samples. The authors report a case of ARN associated with herpes simplex virus-2 (HSV-2) and Epstein–Barr virus (EBV) in an immunocompetent host. A 72-year-old man with a history of herpes zoster ophthalmicus presented with sudden vision loss in the left eye in the setting of hypertensive anterior uveitis and severe vitreous inflammation. ARN was diagnosed and antiviral and steroid treatment was initiated. Vitritis improved 1 week later and foci of retinal necrosis with occlusive vasculitis were observed. Three days later, a rhegmatogenous retinal detachment developed. Pars plana vitrectomy with retinopexy was performed and a vitreous PCR test was positive for both HSV-2 and EBV. Despite retinal reattachment, visual acuity did not improve. Prophylactic antiviral therapy was continued for the fellow eye. The coexistence of more than one virus in the ARN context is exceedingly rare and might be associated with poor visual outcomes.

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