Acute Retinal Necrosis Associated with Herpes Simplex Virus Type II Infection – Case Report

Introduction Acute retinal necrosis is a rare, severe retinitis that may lead to loss of vision. This condition is caused mainly by the Herpesviridae. It can affect both immunocompromised and immunocompetent patients of all ages. Case report A 54-year-old female patient, came to the eye emergency department with a history of rapid and progressive loss of vision in the left eye. Due to uveitis, the disease was treated without any improvement. After ophthalmological examination the diagnosis of acute retinal necrosis was taken into consideration. The patient was treated with a combination of systemic and intravitreal antivirals, together with oral corticosteroids. During hospitalization, pars plana vitrectomy was performed. Herpes simplex 2 found in the sample taken from the vitreous body confirmed the diagnosis. Six weeks after hospitalization, the patient was readmitted to the ophthalmology emergency department with a sudden loss of vision in the left eye. As a consequence, retinal detachment was recognized and the patient was qualified for reoperation. At the last follow-up visit, the patient presented with the best corrected visual acuity at the level of 0.6 in distance, without symptoms of disease activity. Conclusions Due to the rapidly progressive character of acute retinal necrosis, an immediate diagnosis and intensive treatment are crucial. Nevertheless, despite all our efforts, we cannot completely prevent further complications, including retinal detachment.