- Ophthalmic Surgery, Lasers and Imaging
A 41-year-old woman with AIDS presented with progressive nasal visual field loss in her right eye. Ophthalmic examination revealed widespread retinal opacification with hemorrhage consistent with progressive outer retinal necrosis, which was confirmed by polymerase chain reaction for varicella zoster virus DNA. The patient was treated with intravenous and intravitreal foscarnet and ganciclovir with improvement clinically. Optical coherence tomography (OCT) and fundus autofluorescence imaging revealed progressive changes indicative of widespread retinal pigment epithelial (RPE) and outer retinal dysfunction. OCT showed progressive changes in macular architecture, including neurosensory elevation, cystoid macular edema, and severe outer retinal necrosis, at initial examination and 1 week and 1 month of follow-up. Fundus autofluorescence revealed stippled hyperfluorescence within extensive zones of hypofluorescence, which progressed during follow-up. OCT and fundus autofluorescence was useful in the characterization of the RPE and retinal anatomy in this patient with progressive outer retinal necrosis.
From the National Eye Institute (SY, WTW, EDW, JCL, EYC, RBN), National Institutes of Health, Bethesda, Maryland; and the Department of Ophthalmology (EDW), Walter Reed Army Medical Center, Washington, DC.
Presented at the American Society of Retina Specialists Annual Meeting, December 2007, Palm Springs, California.
The views expressed herein are those of the authors and do not necessarily reflect those of the National Institutes of Health or the U.S. Army.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Robert B. Nussenblatt, MD, MPH, National Eye Institute, Laboratory of Immunology, Building 10, 10S-219, 10 Center Dr., Bethesda, MD 20892-1857.