Rapidly Progressive Outer Retinal Necrosis in the Acquired Immunodeficiency Syndrome

Forster, David J.; Dugel, Pravin U.; Frangieh, George T.; Liggett, Peter E.; Rao, Narsing A.

doi:10.1016/s0002-9394(14)77012-6

Cited by 211 publications

(92 citation statements)

References 9 publications

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“…At present, PCR technology is not generally accepted as a standard laboratory procedure, albeit it has been employed for the diagnosis of well-defined necrotizing retinopathies (such as ARN and CMV retinitis) as well as for the detection of DNA from HSV-1 [12,19,37], HSV type 2 [38], VZV [19,31,39], CMV [24,25,35], Epstein-Barr virus [40], and human herpesvirus 6 [36]. Data derived by such means should therefore always be confirmed by established methods.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, cultures of samples from the virtually cell-free aqueous and vitreous compartments are negative; therefore, such means cannot be used to establish viral etiology [9,11,12]. However, analysis of paired aqueous and serum samples for the existence of specific antibodies has led to successful diagnoses in 65% of cases [13][14][15]; if this procedure is carried out on a sequential basis, 72%-86% of cases may be successfully diagnosed [16].…”

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confidence: 99%

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Varicella-Zoster Virus Is Strongly Associated with Atypical Necrotizing Herpetic Retinopathies

Garweg

Böhnke

1997

Clinical Infectious Diseases

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Aqueous humor samples from nine patients with atypical necrotizing retinopathies of suspected viral origin, six with acute retinal necrosis syndrome (ARN), and 17 with active cytomegalovirus (CMV) retinitis underwent amplification for viral DNA of herpes simplex virus type 1 (HSV-1), varicella-zoster virus (VZV), and human CMV. VZV DNA was detected in seven of the nine aqueous humor samples from patients with atypical necrotizing retinopathies of suspected viral origin and in four of the six samples from individuals with ARN; of the two other samples from patients with ARNS, no viral DNA was found in one, and both CMV DNA and HSV-1 DNA, but not VZV DNA, were detected in one (this patient presented with bilateral ARNS 2 months after being successfully treated for CMV retinitis). Thus, VZV is likely to be the main pathogen of atypical necrotizing herpetic retinopathies. DNA amplification may be used to establish an early, sensitive, and reliable diagnosis of any form of necrotizing retinopathy in 80% of cases, irrespective of viral etiology.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Varicella-Zoster Virus Is Strongly Associated with Atypical Necrotizing Herpetic Retinopathies

Garweg

Böhnke

1997

Clinical Infectious Diseases

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“…tients is a rapidly progressive and blinding disorder that can be halted by prompt administration of specific antimicrobial therapy. [1][2][3][4][5] The long-term antimicrobial treatment is essential for the prevention of further attacks or activity in the not yet affected eye. 6 Therefore a rapid identification of the causative agent is indispensable.…”

mentioning

confidence: 99%

Infectious Uveitis in Immunocompromised Patients and the Diagnostic Value of Polymerase Chain Reaction and Goldmann-Witmer Coefficient in Aqueous Analysis

Westeneng¹,

Rothová²,

Boer³

et al. 2007

American Journal of Ophthalmology

112

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• PURPOSE: To establish the causes of uveitis in immunocompromised patients and to determine the contribution of polymerase chain reaction (PCR) and Goldmann-Witmer coefficient (GWC) analysis of aqueous humor in patients with an infectious etiology.• DESIGN: Retrospective case series of 56 consecutive immunocompromised patients with uveitis.• METHODS: All patients underwent full ophthalmologic examination and laboratory blood analysis for uveitis. Aqueous humor analyses were performed using PCR and GWC for cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV), and Toxoplasma gondii.• RESULTS: Of 56 immunocompromised patients, 43 (77%), all posterior and panuveitis, had intraocular infections. Twenty-one (49%) had CMV, three (7%) had VZV, 11 (26%) had T. gondii, six (14%) had Treponema pallidum, and one (2%) each had Aspergillus and Candida. In AIDS patients, CMV was the most common cause. A strong correlation between AIDS and ocular syphilis was also observed (P ‫؍‬ .007). In non-AIDS immunocompromised patients, T. gondii was most frequently detected. Twenty-seven patients were examined by both PCR and GWC; five (18.5%) were positive by both assays, 15 (55.5%) were positive by PCR alone and seven (26%) by GWC alone. Viral infections were detected by PCR in 16 of 17 (94%) cases; T. gondii in four of 10 (40%) patients. Using GWC, a viral infection was diagnosed in three of 17 (18%) and T. gondii in nine of 10 (90%) cases.

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“…A vitreíte costuma aumentar com a evolução da doença, podendo chegar a uma intensidade que dificulta a observação das estruturas do fundo de olho. Com a progressão da necrose retiniana e da inflamação vítrea, pode surgir, semanas ou meses após o início do quadro, descolamento regmatogênico de retina, que geralmente acomete má-cula e grandes áreas da retina, sendo a principal causa de baixa de acuidade visual decorrente desta doença, assim como a sua complicação mais comum, podendo ocorrer em 24 a 80% dos casos (6)(7)(8)(9)(10)(11)(12) .…”

Section: Introductionunclassified

Tratamento da necrose aguda de retina: revisão sistemática

Zajdenweber¹,

Muccioli²

2005

Arq. Bras. Oftalmol.

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Rapidly Progressive Outer Retinal Necrosis in the Acquired Immunodeficiency Syndrome

Cited by 211 publications

References 9 publications

Varicella-Zoster Virus Is Strongly Associated with Atypical Necrotizing Herpetic Retinopathies

Varicella-Zoster Virus Is Strongly Associated with Atypical Necrotizing Herpetic Retinopathies

Infectious Uveitis in Immunocompromised Patients and the Diagnostic Value of Polymerase Chain Reaction and Goldmann-Witmer Coefficient in Aqueous Analysis

Tratamento da necrose aguda de retina: revisão sistemática

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