Bilateral Necrotizing Herpetic Retinopathy Three Years After Herpes Simplex Encephalitis Following Pulse Corticosteroid Treatment

Viral encephalitis complicated by acute retinal necrosis syndrome: A case report

“…Systemic glucocorticoids may alleviate retinal inflammation, and have also been shown to protect the retina and optic nerve. Prophylactic laser coagulation of retinal defects and margins may also prevent retinal detachment (13).…”

Bilateral acute retinal necrosis syndrome following herpes simplex type 1 encephalitis

“…BARN following HSE could only be found in seven case reports. [17][18][19][20][21][22] The majority of patients in the unilateral ARN group had no other factors which might be associated with impaired host defence. In contrast, the reported cases of BARN following encephalitis all had some associated factors that may have reduced host defence.…”

“…17 Two report association with high-dose intrathecal or pulsed intravenous steroid. 18,19 One case occurred during iatrogenic immunosuppression with chemotherapy agents 20 and a further case followed craniotomy and oral dexamethasone for a supra sellar lesion. 21 Finally, there was one case of HSV-2 in a neonate.…”

“…In general, BARN tends to occur quite soon following encephalitis with most reported within 5 months and only one reported after 42 months. 18 We suggest that oral antiviral agents should be introduced after IV therapy for at least 6 months following HSE to reduce the risk of acute retinal necrosis. Oral valaciclovir, a prodrug of aciclovir has excellent bioavailability and is very well tolerated.…”

Necrotizing Herpetic Retinopathy After Intravitreal Triamcinolone Acetonide Injection

“…Multiple cases of NHR have been described in patients receiving treatment with systemic corticosteroids. 1,2 We are unaware of any previous confirmed report of NHR after intravitreal triamcinolone acetonide (TA) injection.…”