Viral causes of the acute retinal necrosis syndrome

Walters, Gavin; James, Teifi

doi:10.1097/00055735-200106000-00008

Cited by 35 publications

(28 citation statements)

References 25 publications

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“…A apresentação inicial é unilateral e varia de acordo com a gravidade. Alguns pacientes desenvolvem perda visual em alguns dias, enquanto outros têm início insidioso, com sintomas visuais leves, tais como moscas volantes (1)(2)(3)(4)(5)(6) . Como sinais clínicos, têm-se uveíte anterior granulomatosa, vitreíte, periarterite periférica ou necrose retiniana.…”

Section: Discussionunclassified

“…As lesões agudas resolvem-se em 6 a 12 semanas, resultando em retina necrótica transparente com bordos hiperpigmentados (1) . Embora o diagnóstico de NAR seja clínico na maioria dos casos, a confirmação etiológica é realizada pela reação em cadeia da polimerase (PCR), para pesquisa viral ou anticorpos antivirais no humor aquoso ou no ví-treo (2,5,6) . A paracentese da câmara anterior para obter o humor aquoso é um procedimento seguro e menos invasivo em relação às técnicas de biópsia do vítreo.…”

Section: Discussionunclassified

“…A paracentese da câmara anterior para obter o humor aquoso é um procedimento seguro e menos invasivo em relação às técnicas de biópsia do vítreo. Walters et al recomendam análise de amostras do aquoso em pacientes com uveítes atípicas ou suspeita de retinite viral (6) . Em estudo retrospectivo de 12 casos realizada por Tran et al, o DNA do virus herpes simples tipo 2 foi detectado em todos os pacientes (4) .…”

Section: Discussionunclassified

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Necrose retiniana aguda por presumível etiologia viral por herpes simples resultando em endoftalmite: relato de caso

Tanaka¹,

Fonseca²,

Helal³

2011

Rev. bras.oftalmol.

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RESUMOA necrose retiniana aguda é uma rara e devastadora retinite necrotizante, que pode ser causada pelo vírus herpes simples tipo 1 ou 2. Afeta tipicamente pacientes saudáveis de todas as idades. Este estudo é um relato de caso de um paciente de 18 anos, previamente hígido, que apresentou necrose aguda de retina por presumível etiologia viral por herpes simples, e descreve sua apresentação clínica e ultrassonográfica. Por não ter sido diagnosticado e tratado precocemente, a necrose retiniana aguda cumpriu sua história natural e evoluiu para um quadro compatível com endoftalmite.

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Section: Discussionunclassified

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Necrose retiniana aguda por presumível etiologia viral por herpes simples resultando em endoftalmite: relato de caso

Tanaka¹,

Fonseca²,

Helal³

2011

Rev. bras.oftalmol.

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“…Multiple members of the Herpes virus family have been identified as the causative agents of ARN syndrome by viral culture, immmunocytochemical studies, retinal biopsy, intraocular antibody production and PCR analysis Pepose et al, 1992;Boer et al, 1994;Abe et al, 1996;Ganatra et al, 2000;Walters and James, 2001;Tran et al, 2003a). VZV accounts for the majority of cases, while other viruses include HSV-1 and HSV-2.…”

Section: Pathogenic Virusesmentioning

confidence: 99%

Herpetic Viral Retinitis

Noma¹

2013

American Journal of Virology

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Human Herpes Virus (HHV) is a DNA virus and is the most important viral pathogen causing intraocular inflammation. HHV is classified into types 1-8. Among these types, HHV-1, HHV-2, HHV-3 Varicella Zoster Virus (VZV) and HHV-5 Cytomegalovirus (CMV) are known to cause herpetic viral retinitis, including acute retinal necrosis and CMV retinitis. Herpes viral retinitis can be diagnosed from characteristic ocular findings and viral identification by PCR of the aqueous humor. Recently, therapy has become more effective than in the past. Herpes viral retinitis gradually progresses if appropriate treatment is not provided with regard to the patient's immune status. Further advances in diagnostic methods and treatment are required in the future.

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“…A cute retinal necrosis syndrome (ARN), one of the most serious infectious ocular diseases, is caused by herpesviruses, with varicella-zoster virus (VZV) being the most common (1,2). Great advances have been made in the diagnosis of viral retinitis with the detection of viral DNA in intraocular fluids (vitreous and aqueous humor [AH]) and accurate quantification of viral genome copies using real-time quantitative PCR (qPCR) (3,4).…”

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confidence: 99%

Time Profile of Viral DNA in Aqueous Humor Samples of Patients Treated for Varicella-Zoster Virus Acute Retinal Necrosis by Use of Quantitative Real-Time PCR

et al. 2013

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The objective of this study was to evaluate the kinetics of varicella-zoster virus (VZV) loads using quantitative PCR (qPCR) in patients treated for acute retinal necrosis (ARN). Six patients (52 ؎ 13 years old) with ARN syndrome were consecutively studied. Aqueous humor (AH) was sampled from both eyes of all patients for qPCR evaluation. The patients were treated with intravenous acyclovir and intravitreal injections of antiviral drugs. The mean follow-up time was 17.6 ؎ 16.4 months. Main outcome measures were the numbers of viral genome copies in the AH, assessed using real-time qPCR with hydrolysis probe technology with a threshold of detection of 200 copies/ml. Two main portions of the viral load curves were observed for each patient: a plateau phase (27.8 ؎ 24.9 days) and a decrease in the number of viral genome copies. The mean baseline viral load was 3.4 ؋ 10 7 ؎ 4.45 ؋ 10 7 copies/ml (6 ؋ 10 6 to 1.2 ؋ 10 8 copies/ml). The viral load decreased according to a logarithmic model, with a 50% reduction obtained in 3 ؎ 0.7 days. There was a significant viral load (>102 copies/ml) at 50 days after the onset of treatment, despite antiviral drugs. qPCR use demonstrated reproducible VZV DNA kinetics with a two-phase evolution: a plateau followed by a logarithmic decrease. These data suggest that high-dosage antiviral therapy administered for the conventional 10-day duration is insufficient for most patients. This series of patients responded with a similar decrease in viral load once treatment was initiated, and the data from these patients may be used to predict the responses of future patients. Acute retinal necrosis syndrome (ARN), one of the most serious infectious ocular diseases, is caused by herpesviruses, with varicella-zoster virus (VZV) being the most common (1, 2). Great advances have been made in the diagnosis of viral retinitis with the detection of viral DNA in intraocular fluids (vitreous and aqueous humor [AH]) and accurate quantification of viral genome copies using real-time quantitative PCR (qPCR) (3, 4).The extent of retinitis, such as anterior chamber and vitreous inflammation, vasculitis, retinal necrosis, and scarring of the involved retina, is currently monitored with physical examination. Vitreous opacities and/or cataract development, however, may preclude visualization of the posterior segment, making clinical monitoring and appraisal of the efficacy of antiviral treatment difficult. At this time, it is not known whether the kinetics of viral DNA during systemic treatment (i.e., acyclovir [5], valacyclovir [6,7], or famciclovir [6-8] and/or intravitreal therapy [9]) is similar in all patients and can be predicted once the treatment is initiated.The objective of this case series was to assess the evolution of VZV DNA loads after systemic/intravitreal antiviral treatment in ARN and to evaluate the contribution of qPCR to the monitoring of patients with VZV acute retinal necrosis. MATERIALS AND METHODSThis retrospective study was conducted in a tertiary center with a consecutive series of s...

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Viral causes of the acute retinal necrosis syndrome

Cited by 35 publications

References 25 publications

Necrose retiniana aguda por presumível etiologia viral por herpes simples resultando em endoftalmite: relato de caso

Necrose retiniana aguda por presumível etiologia viral por herpes simples resultando em endoftalmite: relato de caso

Herpetic Viral Retinitis

Time Profile of Viral DNA in Aqueous Humor Samples of Patients Treated for Varicella-Zoster Virus Acute Retinal Necrosis by Use of Quantitative Real-Time PCR

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