To report a rare case of acute retinal necrosis (ARN) presenting with exudative retinal detachment (ERD) in an adult patient caused by varicella zoster virus (VZV).
Approach:
Case Presentation: A 43-year-old woman presented with acute blurred vision, eye redness, and ocular pain. Initial examination revealed ciliary congestion, vitritis, optic disc swelling, and non-rhegmatogenous retinal detachment. Optical coherence tomography showed optic disc and…
Treatment: Initially treated with corticosteroids, the patient later received systemic intravenous acyclovir, intravitreal ganciclovir, and corticosteroids after VZV was confirmed through metagenomic testing.
Key Findings:
Exudative retinal detachment is a rare early manifestation of ARN.
VZV infection was confirmed through metagenomic testing.
Aggressive antiviral therapy led to rapid resolution of retinal detachment and complete resolution of retinal lesions.
Interpretation:
In cases of uveitis with ERD that do not respond to anti-inflammatory therapy, viral infection, particularly VZV, should be considered.
Limitations:
The study is based on a single case report, limiting generalizability.
Long-term outcomes beyond one month were not assessed.
Conclusion:
Aggressive combined systemic and intravitreal antiviral therapy, along with corticosteroids, is critical for achieving favorable anatomical and visual outcomes in early-stage ARN presenting with ERD.
