Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan.
Ocul Immunol Inflamm. 2022 May 19;30(4):1009-1015. doi: 10.1080/09273948.2020.1841803. Epub 2021 Feb 4.
To report a case of a neonate with acute retinal necrosis, lens vacuoles, and encephalitis associated with herpes simplex virus (HSV) infection.
Case report.
Retrospective chart review.
A male neonate was brought for screening for retinopathy of prematurity at the corrected age of 32 weeks. Slit-lamp examination showed lens vacuoles in both eyes. Fundus examination revealed extensive retinal detachments with prominent retinal whitening, subretinal exudates, and retinal hemorrhage. Computed tomography of the brain showed encephalomalacia. Polymerase chain reaction of cerebrospinal fluid and anterior chamber fluid was both positive for HSV-1. Despite systemic anti-viral therapy, a rhegmatogenous retinal detachment and subsequent proliferative vitreoretinopathy developed in the patient's right eye. The retinal detachment in the left eye resolved, but significant chorioretinal degeneration occurred. With time lens vacuoles decreased in number.
Clinicians should remember this rare, but devastating condition without specific prodromal symptoms.
报告一例新生儿急性视网膜坏死、晶状体空泡和与单纯疱疹病毒（HSV）感染相关的脑炎。
病例报告。
回顾性图表审查。
一名男性新生儿在纠正胎龄 32 周时因早产儿视网膜病变筛查而被送来。裂隙灯检查显示双眼晶状体空泡。眼底检查显示广泛的视网膜脱离，伴有明显的视网膜变白、视网膜下渗出和视网膜出血。脑计算机断层扫描显示脑软化。脑脊髓液和前房液的聚合酶链反应均为单纯疱疹病毒 1 型阳性。尽管进行了全身抗病毒治疗，但患者右眼仍发生孔源性视网膜脱离和随后的增殖性玻璃体视网膜病变。左眼的视网膜脱离已解决，但发生了显著的脉络膜视网膜变性。随着时间的推移，晶状体空泡的数量减少。
临床医生应记住这种罕见但具有破坏性的疾病，它没有特定的前驱症状。
