Zoster-related bilateral acute retinal necrosis syndrome as presenting sign in AIDS

The acute retinal necrosis (ARN) syndrome has recently been associated with intraocular infections with one or more members of the herpesvirus family. There have been 14 cases in the literature linking ARN with a preceding or subsequent herpetic dermatitis. We report the development of bilateral ARN (BARN) after unilateral Herpes zoster ophthalmicus as the presenting sign of acquired immunodeficiency syndrome (AIDS) in a previously healthy man. The development of BARN after diffuse Herpes simplex dermatitis in AIDS patients is also discussed. These cases further illustrate the central role of the herpes-virus family in the etiology of ARN and alert the clinician to a new presenting sign for AIDS.