Svozílková Petra, Ríhová Eva, Diblík Pavel, Kuthan Pavel, Kovarík Zdenek, Kalvodová Bohdana
Department of Ophthalmology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Virol J. 2005 Aug 31;2:77. doi: 10.1186/1743-422X-2-77.
Acute retinal necrosis is a sight-threatening disease caused by the group of herpesviruses. The aim of this paper is to report a case of acute retinal necrosis following ocular trauma in a patient initially treated with vaso-active drugs and corticosteroids for presumed ocular ischemic syndrome.
A 51-years-old otherwise healthy man, who suffered from sudden visual loss in the left eye following contusion, was commenced on vaso-active drugs and systemic corticosteroids for suspected ocular ischemic syndrome with extensive swelling of the optic disc and macular edema. Subsequently, vision in the initially uninvolved right eye decreased. Polymerase chain reaction of vitreous samples and retinal biopsy confirmed varicella zoster virus. Despite intensive treatment with intravenous antiviral medication, the patient became completely blind in both eyes.
Initial treatment of acute, unexplained visual decrease with systemic corticosteroids may lead to visual loss in patients with developing acute retinal necrosis. Ocular trauma could have induced and corticosteroid treatment promoted reactivation of a latent viral infection in our patient.
急性视网膜坏死是一种由疱疹病毒组引起的威胁视力的疾病。本文旨在报告一例眼外伤后发生急性视网膜坏死的病例，该患者最初因疑似眼部缺血综合征接受血管活性药物和皮质类固醇治疗。
一名51岁身体健康的男性，在眼部挫伤后左眼突然视力丧失，因疑似眼部缺血综合征伴视盘广泛肿胀和黄斑水肿，开始接受血管活性药物和全身性皮质类固醇治疗。随后，最初未受累的右眼视力下降。玻璃体样本的聚合酶链反应和视网膜活检证实为水痘带状疱疹病毒。尽管接受了静脉抗病毒药物的强化治疗，患者双眼仍完全失明。
对急性、不明原因视力下降患者初始使用全身性皮质类固醇治疗可能导致急性视网膜坏死患者视力丧失。眼外伤可能诱发了我们患者潜在的病毒感染，而皮质类固醇治疗促进了其重新激活。
