a Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA.
b Massachusetts General Hospital , Boston , Massachusetts , USA.
Ocul Immunol Inflamm. 2018;26(2):199-203. doi: 10.1080/09273948.2016.1207788. Epub 2016 Sep 6.
To report use of intravenous foscarnet or cidofovir for the treatment of refractory acute retinal necrosis (ARN).
Retrospective chart review.
Four immunocompetent men aged 45-90 years presented with ARN from 2008-2014. One patient with two prior episodes of herpes simplex virus (HSV) ARN developed ARN after 6 years of antiviral prophylaxis. His condition worsened on acyclovir followed by intravenous foscarnet but responded to intravenous cidofovir (final VA in involved eye 20/20). Another patient with HSV ARN had received prolonged acyclovir prophylaxis for HSV keratitis; ARN improved after switching from acyclovir to intravenous foscarnet (final VA 20/125). Two patients with varicella zoster virus (VZV) ARN initially responded to acyclovir but developed fellow eye involvement 2-8 weeks later that worsened on acyclovir but responded to intravenous foscarnet (fellow eye final VA 20/20, 20/40).
Cases of HSV or VZV ARN that worsen despite intravenous acyclovir treatment may respond to intravenous foscarnet or cidofovir.
报告使用膦甲酸或更昔洛韦静脉治疗难治性急性视网膜坏死（ARN）的情况。
回顾性图表审查。
2008 年至 2014 年间，4 名免疫功能正常的男性年龄在 45-90 岁之间出现 ARN。1 名曾有 2 次单纯疱疹病毒（HSV）ARN 病史的患者在抗病毒预防 6 年后发展为 ARN。他的病情在阿昔洛韦治疗后恶化，随后改用膦甲酸静脉治疗，但对更昔洛韦静脉治疗有反应（受累眼最终 VA 为 20/20）。另一名患有 HSV ARN 的患者因 HSV 角膜炎接受了长期阿昔洛韦预防治疗；在从阿昔洛韦改为膦甲酸静脉治疗后，ARN 有所改善（最终 VA 为 20/125）。2 名水痘带状疱疹病毒（VZV）ARN 患者最初对阿昔洛韦有反应，但在 2-8 周后对侧眼受累，阿昔洛韦治疗后病情恶化，但对膦甲酸静脉治疗有反应（对侧眼最终 VA 为 20/20、20/40）。
尽管静脉注射阿昔洛韦治疗，但 HSV 或 VZV ARN 恶化的病例可能对膦甲酸或更昔洛韦静脉治疗有反应。
