Bilateral acute retinal necrosis.

A 20-year-old woman lost all useful vision over a 2 1/2-month period as a result of a necrotizing and occlusive vasculitis of the retina. Treatment with prednisone, immunosuppressants, and aspirin was unsuccessful. No systemic manifestations of the disease were found and no cause was discovered. Kodachromes and fluorescein angiograms showed the progression in one eye from normal to near total retinal necrosis. The process began with a mild venous dilation and peripheral arteritis that progressed into an obliterative vasculitis with abrupt vessel dilation, hemorrhages, and retinal swelling. This was followed by necrosis and sloughing of the retina into the vitreous. Vitreous contraction and necrotic retina produced unrepairable retinal detachments.