Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India.
Department of Refractive Surgery, Narayana Nethralaya, Bangalore, India.
Ocul Immunol Inflamm. 2024 Sep;32(7):1457-1461. doi: 10.1080/09273948.2023.2220785. Epub 2023 Jun 20.
Acute retinal necrosis (ARN) as the term suggests is recognized as necrotic inflammation of retina, in contrast to toxoplasma retinochoroiditis where involvement of choroid can be appreciated as choroidal thickening on optical coherence tomography scan during active stage. Secondly, sequelae of ARN, such as chronic anterior uveitis and cystoid macular edema, could be challenging to manage as steroid use in various forms poses a risk of virus reactivation. We present a case of ARN caused by varicella zoster virus with an initial confusing clinical picture with toxoplasma retinochoroiditis, documented with choroidal involvement. The patient also developed a chronic anterior uveitis with macular edema after resolution of ARN which was treated with topical interferon (IFN) alfa 2b therapy with successful outcome. This report supports the recently described choroidal involvement in ARN and suggests topical IFN as a novel treatment in management of chronic macular edema post ARN.
急性视网膜坏死（ARN）顾名思义，是指视网膜的坏死性炎症，与弓形体性视网膜炎不同，在活跃期，光学相干断层扫描可观察到脉络膜受累，表现为脉络膜增厚。其次，ARN 的后遗症，如慢性前葡萄膜炎和囊样黄斑水肿，可能难以治疗，因为各种形式的类固醇使用都有病毒再激活的风险。我们报告一例由水痘带状疱疹病毒引起的 ARN，其初始临床表现与弓形体性视网膜炎混淆，有脉络膜受累的影像学证据。ARN 缓解后，患者还出现了慢性前葡萄膜炎伴黄斑水肿，采用局部干扰素（IFN）α 2b 治疗后取得了良好的效果。本报告支持最近描述的 ARN 中的脉络膜受累，并提出局部 IFN 是治疗 ARN 后慢性黄斑水肿的一种新方法。
