Acute Retinal Necrosis in a Neonate

Hsu, Christina; Moinfar, Nader; Lipman, Brian; Capone, Antonio; Trese, Michael T.

doi:10.1097/icb.0b013e318297f6d5

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…ARN complications have been found to mainly include retinal detachment, with a general detachment rate in patients with ARN of 49% ( 34 ). Retinal detachment was also observed in seven (46.7%) of the 15 pediatric cases of ARN due to HSV-2 in our study ( 14 , 17 – 19 , 21 , 22 ), as shown in Table 1 . Once retinal detachment occurs in children, it predisposes them to more serious consequences than those occurring in adults.…”

Section: Discussionsupporting

confidence: 72%

“…Early diagnosis and therapy are key to maintaining vision and preventing the involvement of the other eye ( 16 ). The diagnostic criteria for ARN include single or multiple retinal necrosis lesions ( 22 ). However, in this case, it had not been previously determined that our patient had severe vitreous opacity in the early stage as her fundus could not be observed, which posed a major challenge to our diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…We reviewed the relevant literature concerning ARN, and identified 14 cases of pediatric ARN due to HSV-2 (10,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Pediatric ARN due to HSV-2 was first reported in 2001 (14).…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Herpes Simplex Virus Type 2 Acute Retinal Necrosis With Viral Encephalitis in Children

Duan

Shang

2022

Front. Med.

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BackgroundFew cases concerning acute retinal necrosis with viral encephalitis in children have been reported, especially cases where the fundus cannot be identified due to severe vitreous opacity in the early stage that makes diagnosis difficult.MethodsWe conducted a retrospective review of an unusual case of herpes simplex virus-2 (HSV-2) acute retinal necrosis with viral encephalitis in an immunocompetent child, along with a review of relevant literature published up to September 2021.ResultAn 11-year-old girl presented with an approximate 20-day history of ocular redness and decreased visual acuity in the left eye. Examination revealed anterior uveitis and vitreous opacity in the left eye. An anterior chamber tap was performed because the fundus could not be observed clearly, and the aqueous humor was positive for HSV-2 DNA. Cerebrospinal fluid also tested positive for HSV-2. She was diagnosed with acute retinal necrosis syndrome and viral encephalitis. The condition was controlled with timely antiviral and steroid therapy. She was also treated with prophylactic laser therapy to prevent retinal detachment during subsequent follow-up. The pathogenesis, diagnosis, and treatment of HSV-2 acute retinal necrosis in children and the association between acute retinal necrosis and viral encephalitis are further discussed, based on published literature.ConclusionHSV-2-related pediatric acute retinal necrosis may be due to the acquisition of subclinical infection with HSV-2 during parturition, followed by reactivation of the virus latent in the body on account of certain factors. Moreover, it may be complicated with viral encephalitis. For suspected cases with invisible fundus, early intraocular fluid examination is especially helpful for differential diagnosis. Early diagnosis, early treatment, and timely prophylactic laser treatment to prevent retinal detachment are key to a better prognosis. Physicians need to pay attention to such suspected cases during diagnosis and treatment.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Case Report: Herpes Simplex Virus Type 2 Acute Retinal Necrosis With Viral Encephalitis in Children

Duan

Shang

2022

Front. Med.

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“…Acute retinal necrosis (ARN), one of the most serious manifestations of HSV infection, is defined as a rapidly progressing necrotizing retinopathy that presents discrete areas of cir cumferential retinal necrosis, along with signs of uveitis, vitreitis, and retinal vasculitis 2) . The potential complications of ARN include ischemic optic neuropathy and exudative retinal detachment that can lead to severe vision loss.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Acute Retinal Necrosis and Encephalomalacia Due to Herpes Simplex Virus Infection in a Premature Infant

et al. 2019

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Herpes simplex virus (HSV) is a common pathogen, that causes a broad spectrum of diseases, ranging from minor skin infections to severe encephalitis and widespread infections. Acute retinal necrosis (ARN), one of the most serious manifestations of HSV infection, is defined as a rapidly progressing necrotizing retinopathy that pre sents discrete areas of circumferential retinal necrosis, along with signs of uveitis, vitreitis, and retinal vasculitis. We encountered a case of a female infant, born at 33 weeks of gestation with a body weight at birth of 2,080 g, who had ARN and encepha lomalacia due to HSV infection. ARN associated with HSV infection should be sus pected when nonspecific retinal exudates are observed in neonates, especially preterm infants.

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