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[A case of AIDS complicated by progressive outer retinal necrosis]
1Department of Ophthalmology, Tokyo Women's Medical University, School of Medicine, Japan.
Background:
The retina may be involved in patients with acquired immunodeficiency syndrome (AIDS). Progressive outer retinal necrosis (PORN) is a liability.
Case:
A 46-year-old female had repeated exacerbations of pulmonary tuberculosis since two years before. Herpes zoster developed in her right trigeminal nerve area two weeks before, leading to a diagnosis of AIDS. She was referred to us for ophthalmological evaluation.
Findings:
Both eyes showed numerous yellowish white patches in the deeper retinal layers. The anterior chamber and the vitreous were almost intact. Herpes zoster virus was identified in the acqueous by the polymerase chain reaction (PCR) method. Systemic acyclovir or ganciclovir failed to prevent rapid extension of fundus lesions, resulting in whole-layer necrosis of the retina. Retinal detachment with multiple breaks developed in both eyes whthin eleven days after the patient was first seen by us. The clinical course was different from acute retinal necrosis and was characteristic of PORN.
Conclusion:
This case illustrates that PORN may develop in patients affected by AIDS.