Bilateral central retinal artery occlusion associated with herpes simplex virus-associated acute retinal necrosis and meningitis: Case report and literature review

Heather M. Weissman, Valerie Biousse, Marcos Coutinho Schechter, Carlos Del Rio, Steven Yeh

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

A 60-year-old woman with a history of recurrent headaches and blurred vision presented with bilateral optic disc edema. Optic neuritis was suspected, and intravenous methylprednisonlone was administered. Her vision declined to hand motions in both eyes, and subsequent evaluation revealed bilateral acute retinal necrosis with bilateral central retinal artery occlusions (CRAO). Aqueous humor polymerase chain reaction analysis was positive for herpes simplex virus (HSV), establishing a diagnosis of HSV-associated bilateral acute retinal necrosis (ARN) and meningitis. CRAO has rarely been reported in association with ARN, and a fulminant course with bilateral CRAO in association with ARN has not been previously reported. This case emphasizes the importance of careful peripheral examination in patients with presumptive optic neuritis, judicious use of systemic corticosteroid in this context, and the retinal vaso-obliterative findings that may be observed in the pathogenesis of ARN.

Original languageEnglish (US)
Pages (from-to)279-283
Number of pages5
JournalOphthalmic Surgery Lasers and Imaging Retina
Volume46
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

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