Kishore Kamal, Jain Sachin, Zarbin Marco A
UIC-Peoria Campus, Peoria, Illinois, USA.
Ophthalmic Surg Lasers Imaging. 2011 Sep 8;42 Online:e87-90. doi: 10.3928/15428877-20110901-06.
A 40-year-old man presented with a visual acuity of 20/400 in his right eye due to acute retinal necrosis involving two inferior quadrants. Diagnostic vitreous tap was positive for varicella zoster virus and he received intravitreal injections of ganciclovir (2 mg/0.1 mL) and dexamethasone (400 mcg/0.1 mL). Oral prednisone was added on day 3 and tapered over 3 months. Lesions showed pigmentation around day 5 and healed by day 9. He developed vitreous hemorrhage 5 months after presentation and was treated with 25-gauge pars plana vitrectomy combined with panretinal photocoagulation. Final follow-up at 7 months showed a visual acuity of 20/30, mild optic atrophy, narrow arteries, healed retinal lesions, and good panretinal photocoagulation. Intravitreal injections of dexamethasone and ganciclovir may have a role as an adjunctive therapy in the management of patients with acute retinal necrosis, particularly those caused by varicella zoster virus.
一名40岁男性因急性视网膜坏死累及两个下象限，右眼视力为20/400。诊断性玻璃体穿刺显示水痘带状疱疹病毒阳性，他接受了玻璃体内注射更昔洛韦（2mg/0.1mL）和地塞米松（400mcg/0.1mL）。第3天加用口服泼尼松，并在3个月内逐渐减量。病变在第5天左右出现色素沉着，第9天愈合。他在就诊5个月后发生玻璃体积血，接受了25G经平坦部玻璃体切除术联合全视网膜光凝治疗。7个月的最终随访显示视力为20/30，轻度视神经萎缩，动脉变窄，视网膜病变愈合，全视网膜光凝效果良好。玻璃体内注射地塞米松和更昔洛韦可能作为辅助治疗手段，用于急性视网膜坏死患者的管理，尤其是由水痘带状疱疹病毒引起的患者。
