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Progressive outer retinal necrosis in an immunocompetent patient

S Carrillo-Pacheco1, M C Vazquez-Marouschek, F Lopez-Checa

  • 1Department of Ophthalmology, Hospital Universitario Virgen del Rocio, Seville, Spain.

Acta Ophthalmologica Scandinavica
|October 1, 1996
PubMed
Summary

Progressive outer retinal necrosis, a severe herpes virus eye infection, is typically seen in immunocompromised individuals. This report details a rare case of this condition occurring in a healthy, immunocompetent teenager, successfully treated with antiviral medication.

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Area of Science:

  • Ophthalmology
  • Virology
  • Infectious Diseases

Background:

  • Progressive outer retinal necrosis (PORN) syndrome is a severe ocular manifestation of herpes virus infection.
  • PORN is characterized by rapid, bilateral retinal necrosis.
  • Historically, PORN has been exclusively reported in patients with compromised immune systems.

Observation:

  • A 16-year-old male with no known immunodeficiency presented with bilateral PORN.
  • Clinical presentation included rapid vision loss and extensive retinal necrosis.
  • Varicella-zoster virus (VZV) was identified as the causative agent through serological testing.

Findings:

  • The patient was immunocompetent, challenging the established understanding of PORN etiology.
  • Prompt treatment with intravenous acyclovir and oral prednisone halted disease progression.

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  • Ocular inflammation and retinal damage were managed effectively with the therapeutic regimen.

    • Implications:

    • This case expands the known spectrum of PORN, demonstrating its occurrence in immunocompetent individuals.
    • Highlights the importance of considering VZV as a cause of necrotizing retinopathy even in healthy patients.
    • Suggests that early diagnosis and aggressive antiviral therapy are crucial for favorable outcomes in PORN, regardless of immune status.