Acute retinal necrosis (ARN) is known to occur in conjunction with primary varicella or chickenpox infection. The majority of ARN cases reported in the literature were of milder form with mild to moderate vitritis, limited retinitis, and rare occurrence of retinal breaks or detachment that responded well to intravenous acyclovir, with or without oral prednisolone. We report a case of unilateral ARN with marked vitritis and retinal necrosis leading to retinal breaks following chickenpox in a 32-year-old healthy lady. This patient was successfully treated with intravenous acyclovir followed by oral acyclovir and orbital floor triamcinolone injections to contain the inflammation with barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity, and to our knowledge, orbital floor triamcinolone therapy was not used earlier to contain ARN inflammation.
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References
Matsuo T, Koyama M, Matsuo N. Acute retinal necrosis as a novel complication of chickenpox in adults. Br J Ophthalmol 1990;74:443–4.
Smith JR, Chee SP. Acute retinal necrosis syndrome complicating chickenpox. Singapore Med J 2000;41:602–3.
Barondes MJ, Tellez F, Siegel A. Acute retinal necrosis after chickenpox in a healthy adult. Ann Ophthalmol 1992;24:335–6.
Culbertson WW, Brod RD, Flynn HW, Taylor BC, Brod BA, Lightman DA, et al. Chickenpox-associated acute retinal necrosis syndrome. Ophthalmology 1991;98:1641–6.
Kelly SP, Rosenthal AR. Chickenpox chorioretinitis. Br J Ophthalmol 1990;74:698–9.
Ehongo-Bidime A, Pereleux A, Zanen A. Necrose retinienne aigue postvaricelleuse. Bull Soc Belge Ophtalmol 1995;255:61–8 (in French).
Capone A, Meredith TA. Central visual loss caused by chickenpox retinitis in a 2-year-old child. Am J Ophthalmol 1992;113:592–3.
Lee WH, Charles SJ. Acute retinal necrosis following chickenpox in a healthy 4 year old patient. Br J Ophthalmol 2000;84:667–72.
Urayama A, Yamada N, Sasaki T, Nishiyama Y, Watanabe H, Wakusawa S, et al. Unilateral acute uveitis with retinal periarteritis and detachment. Jpn J Ophthalmol 1971;25:607–19.
Holland G. Executive committee of the American Uveitis Society. Standard diagnostic criteria for the acute retinal necrosis syndrome. Am J Ophthalmol 1994;117:663–7.
Duker JS, Blumenkranz MS. Diagnosis and management of the acute retinal necrosis (ARN) syndrome. Surv Ophthalmol 1991;35:327–43.
Clarkson JG, Blumenkranz MS, Culbertson WW, Flynn HW Jr, Lewis ML. Retinal detachment following the acute retinal necrosis syndrome. Ophthalmology 1984;91:1665–68.
Riordan-Eva P, Lightman S. Orbital floor steroid injections in the treatment of uveitis. Eye 1994;8:66–9.
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Tajunisah, I., Reddy, S.C. Acute Retinal Necrosis Complicating Chickenpox in a Healthy Adult—A Case Report and Review of Literature. Compr Ther 33, 25–31 (2007). https://doi.org/10.1007/s12019-007-0008-y
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DOI: https://doi.org/10.1007/s12019-007-0008-y