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A case of acute retinal necrosis recurrence caused by herpes simplex virus type 2 Shuhei Seino 1 , Kenichi Namba 1 , Kazuomi Mizuuchi 1 , Daiju Iwata 1 , Kayo Suzuki 1 , Mayuko Shinagawa 1 , Keitaro Hase 1 , Susumu Ishida 1 1Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University pp.1527-1532
Published Date 2021/11/15
DOI https://doi.org/10.11477/mf.1410214222
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Abstract Purpose:Acute retinal necrosis(ARN)can occasionally recur. Herein, we report a case of herpes simplex virus(HSV)-2 ARN with presumed multiple recurrences.

Case:A 12-year-old girl presenting with redness and blurred vision in the right eye(OD)was referred to our hospital.

Findings:Uveitis with vitreous opacity, retinal vessel sheathing, and yellow-white retinal lesions in her peripheral retina OD were noted. Although she was treated with eye drops in her right eye, retinal scars remained. At the age of 22, she visited our hospital with the ocular pain and blurred vision in her right eye. Due to severe anterior chamber inflammation and vitreous opacity, ocular fundus could not be seen OD. HSV DNA was detected by polymerase chain reaction(PCR)testing of a sample of aqueous humor, and HSV ARN was suspected. Treatment with intravenous acyclovir and oral prednisolone resolved vitreous opacity but retinal scarring remained. At the age of 31, she visited our hospital with ocular pain and redness OD. Anterior chamber inflammation, vitreous opacity, retinal vessel sheathing and widespread yellow-white retinal lesions at the temporal periphery OD were observed. The detection of HSV-2 by PCR examination with aqueous humor led to a definite diagnosis of HSV-2 ARN OD. Treatment with intravenous acyclovir and oral prednisolone led to gradual resolution of retinal lesions;however, vitreous opacity worsened and vitrectomy was performed. Since the surgery, the patient has maintained acceptable visual function without retinal detachment after 2 years.

Conclusion:Since HSV ARN may recur after an interval of several years, periodic follow-up should continue after remission.


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