Positive Epstein-Barr virus polymerase chain reaction in a case of acute retinal necrosis

Hamam, Rola N.; Mansour, Ahmad T.; Mollayess, Georges El

doi:10.1016/j.jcjo.2012.07.011

Cited by 15 publications

(21 citation statements)

References 5 publications

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“…However, there are also reports stating that only EBV is associated with ARN development. In these reports, EBV DNA was detected from ocular fluid and retinal tissues that were absent from HSV, VZV or CMV [ 12 , 13 , 14 ]. Among these cases, 1 patient was affected with a lymphoproliferative disorder, and another patient was receiving systemic methylprednisolone and infliximab.…”

Section: Discussionmentioning

confidence: 99%

Acute Retinal Necrosis Associated with Epstein-Barr Virus in a Patient Undergoing Immunosuppressive Therapy

Hiraoka

Tanaka³

et al. 2016

Case Rep Ophthalmol

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Acute retinal necrosis (ARN) is a rapidly progressive and severe retinitis resulting in a poor visual outcome. Infections caused by herpes viruses such as herpes simplex virus (HSV) types 1 and 2 or the varicella zoster virus (VZV) are known to be implicated in the development of ARN. In the present study, an 80-year-old female with ARN was examined. She had been affected with rheumatoid arthritis and had taken methotrexate for over 10 years. Her right eye showed clinical features of ARN, and her left eye showed mild retinitis. The genomic DNA in the aqueous humor and vitreous fluid from her right eye were analyzed by a comprehensive polymerase chain reaction (PCR) assay to screen infectious pathogens including viruses. The Epstein-Barr virus (EBV) was detected from both specimens, but neither HSV or VZV nor cytomegalovirus was detected. She underwent intraocular surgery following systemic corticosteroid and acyclovir applications. However, although the retinitis of her right eye was extinguished, the final visual outcome was blindness due to optic nerve atrophy. There are few reports indicating that EBV is associated with ARN development. The present findings suggest that EBV alone can be the causative agent of ARN.

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Section: Discussionmentioning

confidence: 99%

Acute Retinal Necrosis Associated with Epstein-Barr Virus in a Patient Undergoing Immunosuppressive Therapy

Hiraoka

Tanaka³

et al. 2016

Case Rep Ophthalmol

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“…There is no known racial or gender predilection . EBV has infrequently been implicated as a causative agent and is usually found in conjunction with VZV or immunocompromise . CMV is a rare cause of ARN …”

Section: Acute Retinal Necrosismentioning

confidence: 99%

“…7,16,17 EBV has infrequently been implicated as a causative agent and is usually found in conjunction with VZV or immunocompromise. [10][11][12][18][19][20][21] CMV is a rare cause of ARN. 7,22 Immunocompetence is the traditional hallmark of ARN, however recent studies have observed immune dysfunction due to medications, malignancy, and other systemic disorders in up to 50% of cases.…”

Section: Acute Retinal Necrosismentioning

confidence: 99%

Viral retinitis: diagnosis and management in the era of biologic immunosuppression: A review

Lightman

Tomkins-Netzer

2019

Clinical Exper Ophthalmology

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Necrotising retinitis is a rare ocular infection that historically led to high rates of visual morbidity. While acute retinal necrosis occurs in immunocompetent patients, the majority of cases are associated with immunocompromise such as in cytomegalovirus retinitis and progressive outer retinal necrosis. This review summarises the clinical and diagnostic features, management, and outcomes of herpetic retinitis. Iatrogenic immunosuppression is increasingly being utilised for a wide range of indications, and biologic agents especially so due to their targeted nature. While the intended actions are well‐studied, the flow‐on effects and complex interaction with host immunity are not well understood. Furthermore, biologics are frequently used concomitantly with other immunosuppressive agents, potentiating the immunodepression. This article reviews the literature on biologic immunosuppression and viral retinitis, and presents an approach to the vulnerable or affected patient. Early identification, prompt and aggressive treatment, and a multidisciplinary approach to managing immunodeficiency are the cornerstones of management.

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“…Although EBV is not a common pathogen in ocular inflammation, a few cases of ARN in association with EBV have been reported. [13][14][15][16] In conclusion, immunocompetent hosts may be affected by herpetic CNS disease with ocular involvement. Therefore, neuro-ophthalmological examination and retinal screening may be justified in individuals with signs of herpetic encephalitis, especially if there are complaints of floaters or blurred vision.…”

mentioning

confidence: 94%

Fourth Cranial Nerve Palsy and Bilateral Acute Retinal Necrosis following Human Herpesvirus 6 Infection of the Central Nervous System

Papageorgiou

Ch'ng

Kulkarni

et al. 2013

Ocular Immunology and Inflammation

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Positive Epstein-Barr virus polymerase chain reaction in a case of acute retinal necrosis

Cited by 15 publications

References 5 publications

Acute Retinal Necrosis Associated with Epstein-Barr Virus in a Patient Undergoing Immunosuppressive Therapy

Acute Retinal Necrosis Associated with Epstein-Barr Virus in a Patient Undergoing Immunosuppressive Therapy

Viral retinitis: diagnosis and management in the era of biologic immunosuppression: A review

Fourth Cranial Nerve Palsy and Bilateral Acute Retinal Necrosis following Human Herpesvirus 6 Infection of the Central Nervous System

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