- Ophthalmic Surgery, Lasers and Imaging
A 40-year-old man presented with a visual acuity of 20/400 in his right eye due to acute retinal necrosis involving two inferior quadrants. Diagnostic vitreous tap was positive for varicella zoster virus and he received intravitreal injections of ganciclovir (2 mg/0.1 mL) and dexamethasone (400 mcg/0.1 mL). Oral prednisone was added on day 3 and tapered over 3 months. Lesions showed pigmentation around day 5 and healed by day 9. He developed vitreous hemorrhage 5 months after presentation and was treated with 25-gauge pars plana vitrectomy combined with panretinal photocoagulation. Final follow-up at 7 months showed a visual acuity of 20/30, mild optic atrophy, narrow arteries, healed retinal lesions, and good panretinal photocoagulation. Intravitreal injections of dexamethasone and ganciclovir may have a role as an adjunctive therapy in the management of patients with acute retinal necrosis, particularly those caused by varicella zoster virus.
From UIC-Peoria Campus (KK, SJ), Peoria, Illinois; Illinois Retina Institute (KK), Peoria, Illinois; and the Institute of Ophthalmology and Visual Science-New Jersey Medical School (MAZ), Newark, New Jersey.
Presented as poster at the 28th annual meeting of American Society of Retina Specialists; August 28–September 1, 2010; Vancouver, British Columbia, Canada.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Kamal Kishore, MD, Illinois Retina Institute S.C., 5016 N. University, Suite 106, Peoria, IL 61614. E-mail: email@example.com