Acute retinal necrosis syndrome following herpes zoster dermatitis

The acute retinal necrosis (ARN) syndrome has been recently linked to intraocular infection with one or more members of the herpesvirus family. The authors report two cases of ARN following herpes zoster skin eruptions, and one case following ipsilateral facial nerve palsy (Ramsay Hunt syndrome). Evaluation of serial serum antibody titers against cytomegalovirus (CMV), herpes simplex virus (HSV) (types 1 and 2), and varicella zoster (VZ) virus revealed diagnostic changes for VZ virus alone following the retinitis. Immune precipitation of radiolabeled VZ proteins by these sera followed by gel fractionation yielded radioimmune precipitation profiles characteristic of a recent zoster reactivation. These cases further implicate a central role for VZ virus infection in the etiology of the ARN syndrome.