To report a case of recurrent acute retinal necrosis (ARN) in an eye filled with silicone oil previously complicated by rhegmatogenous retinal detachment (RRD).
Observations
A 68-year-old gentlemen with successfully treated herpes simplex virus type 1 (HSV1) ARN complicated by RRD requiring pars plana vitrectomy (PPV) with silicone oil tamponade, presented with a relapse of ARN with silicone oil in situ. Remission of recurrent retinitis was achieved using combined systemic oral and intravitreal antiviral therapy.
Conclusions and Importance
RRD is a significant complication of ARN which may require surgery with silicone oil tamponade. Recurrence of ARN retinitis can be effectively treated with intravitreal Ganciclovir and Foscarnet injections in a silicone oil filled eye with concurrent oral antiviral therapy. Aqueous humour sampling proved useful in the monitoring of disease activity.
MuthiahMNMichaelidesMChildCS,et al.Acute retinal necrosis: a national population-based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK. Br J Ophthalmol2007; 91: 1452–1455.
2.
CochraneTFSilvestriGMcDowellC,et al.Acute retinal necrosis in the United Kingdom: results of a prospective surveillance study. Eye (Lond)2012; 26: 370–377. quiz 8.
3.
GanatraJBChandlerDSantosC,et al.Viral causes of the acute retinal necrosis syndrome. Am J Ophthalmol2000; 129: 166–172.
4.
WongRWJumperJMMcDonaldHR, et al.Emerging concepts in the management of acute retinal necrosis. Br J Ophthalmol2013; 97: 545–552.
5.
TaylorSRHamiltonRHooperCY, et al.Valacyclovir in the treatment of acute retinal necrosis. BMC Ophthalmol2012; 12: 48.
6.
ShanthaJGWeissmanHMDebiecMR,et al.Advances in the management of acute retinal necrosis. Int Ophthalmol Clin2015; 55: 1–13.
7.
WongRPavesioCELaidlawDA,et al.Acute retinal necrosis: the effects of intravitreal foscarnet and virus type on outcome. Ophthalmology2010; 117: 556–560.
8.
SchoenbergerSDKimSJThorneJE, et al.Diagnosis and treatment of acute retinal necrosis: a report by the American academy of ophthalmology. Ophthalmology2017; 124: 382–392.
9.
RisseeuwSde BoerJHTen Dam-van LoonNH,et al.Risk of rhegmatogenous retinal detachment in acute retinal necrosis with and without prophylactic intervention. Am J Ophthalmol2019; 206: 140–148.
10.
HillenkampJNölleBBrunsC,et al.Acute retinal necrosis: clinical features, early vitrectomy, and outcomes. Ophthalmology2009; 116: 1971–5.e2.
11.
XuYYouYDuW, et al.Ocular pharmacokinetics of bevacizumab in vitrectomized eyes with silicone oil tamponade. Invest Ophthalmol Vis Sci2012; 53: 5221–5226.
12.
Tran THCCassouxNBodaghiB,et al.Successful treatment with combination of systemic antiviral drugs and intravitreal ganciclovir injections in the management of severe necrotizing herpetic retinitis. Ocul Immunol Inflamm2003; 11: 141–144.
13.
MeshiAFriehmannASellaS, et al.Intravitreal administration of antiviral agents in silicone oil-filled human eyes. Ophthalmol Retina2017; 1: 288–293.
14.
AizmanAJohnsonMWElnerSG. Treatment of acute retinal necrosis syndrome with oral antiviral medications. Ophthalmology2007; 114: 307–312.
15.
QianZLiHTaoY,et al.Initial intravitreal injection of high-dose ganciclovir for cytomegalovirus retinitis in HIV-negative patients. BMC Ophthalmol2018; 18: 314.
16.
DonovanCPLevisonALLowderCY,et al.Delayed recurrence of acute retinal necrosis (ARN): a case series. J Clin Virol2016; 80: 68–71.
17.
AppanrajRDuraiswamyHSaravananV,et al.Intravitreal bevacizumab for iatrogenic choroidal neovascular membrane following vitreoretinal surgery for retinal detachment. Indian J Ophthalmol2020; 68: 1201–1203.
18.
CascavillaMLQuerquesGQuerquesL,et al.Intravitreal ranibizumab for myopic choroidal neovascularization after pars plana vitrectomy and silicone oil tamponade. Eur J Ophthalmol2013; 23: 913–916.
19.
ChhablaniJNarayananR. Anti-VEGF therapy in a silicone oil-filled myopic eye with choroidal neovascularisation. BMJ Case Rep2015; 2015.
20.
EngKTLamWCParkerJA,et al.Retinal toxicity of intravitreal ganciclovir in rabbit eyes following vitrectomy and insertion of silicone oil. Can J Ophthalmol2004; 39: 499–505.
21.
PerkinsSLYangCHAshtonPA,et al.Pharmacokinetics of the ganciclovir implant in the silicone-filled eye. Retina2001; 21: 10–14.
22.
HegazyHMKivilcimMPeymanGA, et al.Evaluation of toxicity of intravitreal ceftazidime, vancomycin, and ganciclovir in a silicone oil-filled eye. Retina1999; 19: 553–557.
23.
YanHLiJ. Experimental study on antiviral activity of silicone oil in vitro. Graefes Arch Clin Exp Ophthalmol2008; 246: 1285–1289.
