Posterior pole involvement as the presenting feature of varicella zoster virus- associated acute retinal necrosis in a young healthy man

Posterior pole involvement as the initial manifestation of ARN in immunocompetent individuals is uncommon. This case highlights the importance of recognizing atypical clinical phenotypes of ARN. While the intensive medical therapy did not prevent the loss of retinal tissue, it successfully halted the progression of the infection toward the fovea, thereby allowing the preservation of excellent final visual acuity. Although uncommon, macular involvement should be included in the differential diagnosis of viral retinopathies. Prompt diagnosis and appropriate antiviral therapy are critical to preserving visual function and preventing further complications.