Progressive outer retinal necrosis: Difference between revisions
From IDWiki
(Created page with "== Background == * On the spectrum of necrotizing herpetic retinopathy, with acute retinal necrosis on the other end of the spectrum === Microbiology === * Overwhel...") |
No edit summary |
||
Line 1: | Line 1: | ||
− | == |
+ | ==Background== |
− | * |
+ | *On the spectrum of [[necrotizing herpetic retinopathy]], with [[acute retinal necrosis]] on the other end of the spectrum |
− | === |
+ | ===Microbiology=== |
− | * |
+ | *Overwhelmingly caused by [[varicella-zoster virus]], followed by [[herpes simplex virus]] and rarely by [[cytomegalovirus]] |
− | === |
+ | ===Epidemiology=== |
− | * |
+ | *Most closely associated with advanced HIV (typically with CD4 counts less than 50-100) |
− | == |
+ | ==Clinical Manifestions== |
− | * |
+ | *Rapidly progressing necrosis of the outer retina, in an immunocompromised patient |
− | * |
+ | *22% have past medical history of cutaneous zoster, half of which had it in a V1 distribution |
− | * |
+ | *May have concurrent cutaneous or central nervous system involvement |
− | * |
+ | *May appear similar to [[central retinal arterial occlusion]] |
+ | |||
+ | === Prognosis === |
||
+ | |||
+ | * Poor, which most patients becoming blind despite treatment |
||
+ | * Vision is better if they get intravitreal injections |
||
+ | |||
+ | == Management == |
||
+ | |||
+ | * Consult Ophthalmology |
||
+ | * [[Ganciclovir]] may be more effective than [[acyclovir]] |
||
+ | * Should get concomitant intravitreal [[ganciclovir]] or [[foscarnet]] |
||
[[Category:Herpesviridae]] |
[[Category:Herpesviridae]] |
Latest revision as of 14:43, 13 February 2021
Background
- On the spectrum of necrotizing herpetic retinopathy, with acute retinal necrosis on the other end of the spectrum
Microbiology
- Overwhelmingly caused by varicella-zoster virus, followed by herpes simplex virus and rarely by cytomegalovirus
Epidemiology
- Most closely associated with advanced HIV (typically with CD4 counts less than 50-100)
Clinical Manifestions
- Rapidly progressing necrosis of the outer retina, in an immunocompromised patient
- 22% have past medical history of cutaneous zoster, half of which had it in a V1 distribution
- May have concurrent cutaneous or central nervous system involvement
- May appear similar to central retinal arterial occlusion
Prognosis
- Poor, which most patients becoming blind despite treatment
- Vision is better if they get intravitreal injections
Management
- Consult Ophthalmology
- Ganciclovir may be more effective than acyclovir
- Should get concomitant intravitreal ganciclovir or foscarnet