[Fulminant acute retinal necrosis 10 months after ipsilateral herpes simplex virus encephalitis - a case report]

Cases of acute retinal necrosis caused by herpes simplex virus are rare. We present here a case with a very fast progression 10 months after a primary herpetic encephalitis in an immunocompetent patient.

A 36-year-old otherwise healthy man presented in our hospital with an acute painless loss of vision on the left eye. Initial examination of the fundus showed peripheral retinal necrosis with intra- and preretinal haemorrhages and sheathing of retinal venules. Diagnosis was made by detection of viral DNA in vitreous fluid. Although an antiviral therapy with high doses of acyclovir was started, a vitrectomy with silicon oil instillation was necessary to stabilise the necrotic retina.

Acute retinal necrosis is relatively rare, and fast diagnosis is required. A detailed case history with attention to previous infections with herpes simplex virus as well as clinical signs were the key for the diagnosis.