Abstract
Purpose: To describe the rare entity of concurrent herpetic acute retinal necrosis (ARN) and orbital inflammation. Observations: Two cases of ARN with simultaneous orbital inflammation are described. A 40-year old male presented with a painful left eye and hand motion visual acuity (VA). Both panuveitis and orbital inflammation with involvement of the sclera and optic nerve were observed. He was initially treated with oral steroid therapy, after which the orbital inflammation improved but the panuveitis remained. A diagnostic anterior chamber paracentesis was positive for HSV-2 by PCR. He was started on systemic antivirals, but ultimately developed a retinal detachment. The second patient was an 18-year old female with hand motion VA in the left eye. Panuveitis and severe conjunctival chemosis were observed. MRI demonstrated dacryoadenitis with preseptal inflammation. The patient was initially started on oral steroid therapy, which alleviated the orbital inflammation but not the intraocular inflammation. An anterior chamber diagnostic paracentesis was positive for HSV-1, after which the patient underwent vitrectomy for a retinal detachment. The patient was started on systemic antiviral therapy. Conclusions and Importance: Herpetic disease should remain on the differential for cases of concurrent intraocular and orbital inflammation. Early recognition of this process may help prevent severe vision loss. It is important to recognize that orbital inflammation secondary to herpetic disease may be diverse in its presentation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 47-50 |
| Number of pages | 4 |
| Journal | American Journal of Ophthalmology Case Reports |
| Volume | 14 |
| DOIs | |
| State | Published - Jun 1 2019 |
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Keywords
- Acute retinal necrosis (ARN)
- Orbital inflammation
ASJC Scopus subject areas
- Ophthalmology
Cite this
Concurrent acute retinal necrosis and orbital inflammation : Report of 2 cases. / Swaminathan, Swarup S.; Yannuzzi, Nicolas A.; Rong, Andrew J.; Crane, Ashley M.; Albini, Thomas A.
In: American Journal of Ophthalmology Case Reports, Vol. 14, 01.06.2019, p. 47-50.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Concurrent acute retinal necrosis and orbital inflammation
T2 - Report of 2 cases
AU - Swaminathan, Swarup S.
AU - Yannuzzi, Nicolas A.
AU - Rong, Andrew J.
AU - Crane, Ashley M.
AU - Albini, Thomas A
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Purpose: To describe the rare entity of concurrent herpetic acute retinal necrosis (ARN) and orbital inflammation. Observations: Two cases of ARN with simultaneous orbital inflammation are described. A 40-year old male presented with a painful left eye and hand motion visual acuity (VA). Both panuveitis and orbital inflammation with involvement of the sclera and optic nerve were observed. He was initially treated with oral steroid therapy, after which the orbital inflammation improved but the panuveitis remained. A diagnostic anterior chamber paracentesis was positive for HSV-2 by PCR. He was started on systemic antivirals, but ultimately developed a retinal detachment. The second patient was an 18-year old female with hand motion VA in the left eye. Panuveitis and severe conjunctival chemosis were observed. MRI demonstrated dacryoadenitis with preseptal inflammation. The patient was initially started on oral steroid therapy, which alleviated the orbital inflammation but not the intraocular inflammation. An anterior chamber diagnostic paracentesis was positive for HSV-1, after which the patient underwent vitrectomy for a retinal detachment. The patient was started on systemic antiviral therapy. Conclusions and Importance: Herpetic disease should remain on the differential for cases of concurrent intraocular and orbital inflammation. Early recognition of this process may help prevent severe vision loss. It is important to recognize that orbital inflammation secondary to herpetic disease may be diverse in its presentation.
AB - Purpose: To describe the rare entity of concurrent herpetic acute retinal necrosis (ARN) and orbital inflammation. Observations: Two cases of ARN with simultaneous orbital inflammation are described. A 40-year old male presented with a painful left eye and hand motion visual acuity (VA). Both panuveitis and orbital inflammation with involvement of the sclera and optic nerve were observed. He was initially treated with oral steroid therapy, after which the orbital inflammation improved but the panuveitis remained. A diagnostic anterior chamber paracentesis was positive for HSV-2 by PCR. He was started on systemic antivirals, but ultimately developed a retinal detachment. The second patient was an 18-year old female with hand motion VA in the left eye. Panuveitis and severe conjunctival chemosis were observed. MRI demonstrated dacryoadenitis with preseptal inflammation. The patient was initially started on oral steroid therapy, which alleviated the orbital inflammation but not the intraocular inflammation. An anterior chamber diagnostic paracentesis was positive for HSV-1, after which the patient underwent vitrectomy for a retinal detachment. The patient was started on systemic antiviral therapy. Conclusions and Importance: Herpetic disease should remain on the differential for cases of concurrent intraocular and orbital inflammation. Early recognition of this process may help prevent severe vision loss. It is important to recognize that orbital inflammation secondary to herpetic disease may be diverse in its presentation.
KW - Acute retinal necrosis (ARN)
KW - Orbital inflammation
UR - http://www.scopus.com/inward/record.url?scp=85061916244&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061916244&partnerID=8YFLogxK
U2 - 10.1016/j.ajoc.2019.01.012
DO - 10.1016/j.ajoc.2019.01.012
M3 - Article
AN - SCOPUS:85061916244
VL - 14
SP - 47
EP - 50
JO - American Journal of Ophthalmology Case Reports
JF - American Journal of Ophthalmology Case Reports
SN - 2451-9936
ER -