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November 1996

Clinicopathologic Correlations in Acute Retinal Necrosis Caused by Herpes Simplex Virus Type 2

Author Affiliations

From the Departments of Ophthalmology (Drs Rahhal, Siegel, and Freeman), Pathology (Dr Russak), and Medicine (Dr Rickman), University of California, San Diego School of Medicine, La Jolla; the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (Dr Wiley); and the Department of Pediatrics, University of Colorado School of Medicine, Denver (Drs Tedder and Weinberg). None of the authors have any financial interest in any of the products or techniques described in this article.

Arch Ophthalmol. 1996;114(11):1416-1419. doi:10.1001/archopht.1996.01100140616019

The acute retinal necrosis syndrome is a rapidly progressive and potentially devastating disease. A case of acute retinal necrosis developed in an immunocompetent man, presumably due to the stress, trauma, or immunomodulation related to a craniotomy for a parasellar craniopharyngioma. Vitrectomy and endoretinal biopsy were performed. Polymerase chain reaction studies of the vitreous revealed herpes simplex virus type 2 as the cause, which has not been previously well documented. Results of cerebrospinal fluid antibody studies were also consistent with the diagnosis. Results of cytology and histopathologic examination demonstrated extensive retinal destruction and mononuclear cell infiltration. Sloughing of the inner retina was evidenced by the presence of retinal vascular remnants in the vitreous cytology specimen. As is characteristic of this disease, the visual outcome of this patient was poor.

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