Systemic acyclovir and vitrectomy was effective in a case of acute retinal necrosis Yasuyuki Suzuki 1 , Manabu Mochizuki 2 , Makio Ohara 3 , Akira Kurata 4 1Dept of Ophthalmol, Univ of Tokyo Sch of Med 2Dept of Ophthalmol, Branch Hosp, Univ of Tokyo Sch of Med 3Dept of Ophthalmol, Musashino Red Cross Hosp 4Dept of Pathol, National Institute of Health pp.363-366
Published Date 1990/3/15
DOI https://doi.org/10.11477/mf.1410908110
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A 39-year-old female presented with severe visual impairment, ocular pain and hyperemia in her right eye of 3 weeks' duration. We diagnosed her as Kirisawa-type uveitis, or acute retinal ne-crosis. The aqueous aspirate from the affected eye showed varicella-zoster virus positive cells by direct immunofluorescence method. She was treat-ed with intravenous acyclovir, 45mg/kg/day, for 2 weeks. We performed vitrectomy along with intravitreal infusion of acyclovir and prophylactic scleral buckling 3 weeks after initially seen by us. The inflammation subsided without recurrence or secondary retinal detachment. The visual acuity recovered from finger counting initially to 0.9 10 weeks after surgery and to 1.0 another 20 months later.

This case suggests that varicella-zoster virus may be one of the causative agents for acute retinal necrosis. Intensive treatments with systemic acy-clovir and vitrectomy may be crucial in saving the affected eye.

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