Abstract
Background
To report a case of severe acute retinal necrosis syndrome (ARN) associated with initial features of orbital cellulitis.
Methods
A 49-year-old immunocompetent woman presented with unilateral painful orbital inflammation associated with deep visual loss due to ARN. Polymerase chain reaction (PCR) for detection of viral DNA was applied to ocular fluids. Immunohistochemistry for detection of viral antigens and histopathologic studies were performed on orbital biopsy specimens.
Results
HSV-2 DNA was detected by PCR in ocular fluids. Orbital biopsy disclosed non-specific inflammation without viral replication. Orbital inflammation resolved rapidly after the initiation of antiviral drugs, whereas intraocular inflammation worsened. Final ophthalmic examination disclosed no light perception due to optic atrophy.
Conclusion
ARN and cellulitis may be associated. Consequently, ARN should be investigated in all patients with orbital inflammation, in order to initiate immediately an appropriate antiviral strategy.
Similar content being viewed by others
References
Bloom JN (1977) Herpes simplex retinitis and encephalitis in an adult. Arch Ophthalmol 95:1798
Blumenkranz MS (1986 ) Treatment of the acute retinal necrosis syndrome with intravenous acyclovir. Ophthalmology 93:296–300
Holland GN (1994) Standard diagnostic criteria for the acute retinal necrosis syndrome. Am J Ophthalmol 117:663–667
Tran TH, Rozenberg F, Cassoux N, Rao NA, LeHoang P, Bodaghi B (2003) Polymerase chain reaction analysis of aqueous humor samples in necrotizing viral retinitis. Br J Ophthalmol 87:79–83
Tornerup NR, Fomsgaard A, Nielsen NV (2000) HSV-1-induced acute retinal necrosis syndrome presenting with severe inflammatory orbitopathy, proptosis, and optic nerve involvement. Ophthalmol 107(2):397–401
Vardy SJ, Rose GE (1994) Orbital disease in herpes zoster ophtalmicus. Eye 8(Pt 5):577–579
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rozenbaum, O., Rozenberg, F., Charlotte, F. et al. Catastrophic acute retinal necrosis syndrome associated with diffuse orbital cellulitis: a case report. Graefe's Arch Clin Exp Ophthalmol 245, 161–163 (2007). https://doi.org/10.1007/s00417-006-0265-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-006-0265-y