Clinical Manifestation of Self-Limiting Acute Retinal Necrosis
| Autor: | Joanna Brydak-Godowska, Dariusz Kecik, Piotr K. Borkowski, Szymon Szczepanik, Joanna Moneta-Wielgoś |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Acyclovir Retinitis Central Nervous System Viral Diseases - cerebrospinal fluid Acyclovir - analogs & derivatives Antiviral Agents Gastroenterology Young Adult Clinical Research Acyclovir - standards Antiphospholipid syndrome Prednisone Internal medicine medicine Humans Cerebral venous sinus thrombosis Acyclovir - therapeutic use Aspirin business.industry Retinal Necrosis Syndrome Acute Valine General Medicine Middle Aged medicine.disease Surgery Valacyclovir Female Central Nervous System Viral Diseases - etiology Acute retinal necrosis business Meningitis Encephalitis medicine.drug |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 |
| DOI: | 10.12659/msm.890469 |
| Popis: | Background: The purpose of this paper was to present a case series of self-limiting, peripheral acute retinal necrosis and to demonstrate efficacy of treatment with valacyclovir in patients resistant to acyclovir. The diagnosis was made on ophthalmoscopic examination and positive serum tests for herpes viruses. Material/Methods: Ten patients (6F and 4M) aged 19–55 years were diagnosed and treated for self-limiting acute retinal necrosis (ARN). The following endpoints were reported: visual outcomes, clinical features, disease progression, treatment, and complications. Patients received only symptomatic treatment because they did not consent to vitreous puncture. Results: Peripheral, mild retinitis was diagnosed in all eyes at baseline. Initially, all patients were treated with systemic acyclovir (800 mg, 5 times a day), prednisone (typically 40–60 mg/day), and aspirin in an outpatient setting. In 6 patients, treatment was discontinued at 6 months due to complete resolution of the inflammatory process. Four patients with immune deficiency showed signs and symptoms of chronic inflammation. Two patients did not respond to acyclovir (2 non-responders); however, those patients were successfully treated with valacy clovir. Complete resolution of inflammatory lesions was observed in 8 patients. In 2 patients, the disease pro gressed despite treatment – 1 female patient after kidney transplant who stopped the prescribed medications, and 1 male patient with SLE and antiphospholipid syndrome who experienced breakthrough symptoms ontreatment. He died due to cerebral venous sinus thrombosis. Neurological complications (encephalitis and meningitis) were observed in 2 female patients. Prophylactic laser photocoagulation was performed in 1 subject. Conclusions: A series of cases of self-limiting acute retinal necrosis (ARN) is presented. This clinical form of ARN can resemble toxoplasmic retinitis in some cases. Oral antiviral medications provide an effective alternative to intrave nous formulations in patients with self-limiting ARN. Retinitis is associated with the risk of encephalitis. |
| Databáze: | OpenAIRE |
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