Clinicopathologic correlations in acute retinal necrosis caused by herpes simplex virus type 2
F. M. Rahhal, L. M. Siegel, V. Russak, C. A. Wiley, D. G. Tedder, A. Weinberg, L. Rickman and W. R. Freeman
Department of Ophthalmology, University of California, San Diego School of Medicine, La Jolla, USA.
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.
