J Korean Ophthalmol Soc.  2001 Oct;42(10):1504-1508.

Bilateral acute retinal necrosis that followed unilateral optic neuropathy

• Kim SK
• Kang SW

Abstract

PURPOSE: There have been several reports of optic neuropathy preceding acute retinal necrosis(ARN) in patients with acquired immunodeficiency syndrome. We report one case of bilateral ARN that followed unilateral optic neuropathy in otherwise healthy person.
METHODS
We report on a previous healthy 54-year old man who developed unilateral optic neuropathy 8 weeks after varicella-zoster dermatitis. Central retinal vascular obstruction developed subsequently in his ipsilateral eye. Later on, classic presentation of ARN appeared in his contralateral eye.
RESULTS
The patient was diagnosed with bilateral ARN that followed unilateral optic neuropathy. Intravenous acyclovir stopped the progression of retinitis and resulted in healing of retinal lesions.
CONCLUSIONS
ARN is a visually devastating clinical syndrome of which prompt diagnosis and early treatment are important in improvement the overall prognosis. This case suggests that optic neuropathy, especially with preceding shingles, should be suspected as prodrome of ARN which necessitates prompt initiation of antiviral therapy.

Keyword

Acute retinal necrosis; Optic neuropathy; Varicella-zoster

MeSH Terms

Acquired Immunodeficiency Syndrome
Acyclovir
Dermatitis
Diagnosis
Herpes Zoster
Humans
Middle Aged
Optic Nerve Diseases*
Prognosis
Retinal Necrosis Syndrome, Acute*
Retinaldehyde
Retinitis
Acyclovir
Retinaldehyde