Viral caue of the acute retinal necroi yndrome

PURPOE: The primary goal of thi tudy wa to determine the viral caue of the acute retinal necroi yndrome in 28 patient (30 eye). A econdary goal wa to invetigate poible aociation between viral caue and patient age, and viral caue and central nervou ytem dieae. METHOD: A retropective cae erie in which we reviewed the laboratory reult and clinical hitorie of 28 patient (30 eye) diagnoed with acute retinal necroi yndrome, from whom vitreou or aqueou pecimen were received, for diagnotic evaluation uing previouly decribed polymerae chain reaction–baed aay. REULT: Varicella-zoter viru, herpe implex viru, and cytomegaloviru (CMV) DNA were detected in aqueou and/or vitreou pecimen from 27 of 28 patient (29 of 30 eye with a clinical hitory of acute retinal necroi yndrome). No ample wa poitive for DNA from more than one viru. Varicella-zoter viru DNA wa detected in 13 patient (15 eye). Median age wa 57 year. Herpe implex viru type 1 DNA wa detected in even patient (even eye). Median age wa 47 year. ix of thee patient had a hitory of herpe implex viru encephaliti. Herpe implex viru type 2 DNA wa detected in ix patient (ix eye). Median age wa 20 year. Three of thee patient had a likely hitory of meningiti. Cytomegaloviru DNA wa detected in one patient who wa immunouppreed iatrogenically. No viral DNA wa detected in one patient from whom a ample wa taken after 6 week of acyclovir therapy. CONCLUION: The data ugget that varicella-zoter viru or herpe implex viru type 1 caue acute retinal necroi yndrome in patient older than 25 year, wherea herpe implex viru type 2 caue acute retinal necroi in patient younger than 25 year. A hitory of central nervou ytem infection in a patient with acute retinal necroi yndrome ugget that herpe implex viru i likely to be the viral caue.