Catastrophic acute retinal necrosis syndrome associated with diffuse orbital cellulitis: a case report

Rozenbaum, O.; Rozenberg, Flore; Charlotte, Frédéric; Bodaghi, Bahram

doi:10.1007/s00417-006-0265-y

Cited by 11 publications

(3 citation statements)

References 6 publications

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“…Concurrent ARN and orbital inflammation is rare. Table 1 reviews our two cases with similar cases published in the literature 7, 8, 9, 10, 11. Notably, all cases with one exception were in female patients.…”

Section: Discussionmentioning

confidence: 60%

“…The patient described in Badilla et al had been previously treated for herpes zoster ophthalmicus, 11 and this prior course of antiviral therapy might have facilitated her excellent final VA of 20/25. However, in Rozenbaum et al , 10 the patient progressed to develop a retinal detachment even while on antiviral therapy.…”

Section: Discussionmentioning

confidence: 93%

“…One question that arises is whether the orbital inflammation in these presentations is solely a reaction to the viral infection of the eye, or an active viral infection within orbital tissues. Rozenbaum et al completed a lacrimal gland biopsy, which showed a lymphocytic infiltrate 10 . Immunohistochemistry was negative for HSV, suggesting that the orbital findings are part of a reactionary inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

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Concurrent acute retinal necrosis and orbital inflammation: Report of 2 cases

Swaminathan

Yannuzzi

Rong

et al. 2019

American Journal of Ophthalmology Case Reports

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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.

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