BILATERAL ACUTE RETINAL NECROSIS IN A PAT IENT WITH ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME

A case of bilateral progressive outer retinal necrosis occurred after herpes zoster ophthalmicus in a patient with acquired immunodeficiency syndrome. This case does not correspond to the classical picture of p rogressive outer retinal necrosis. The disease led to blindness despit e intravenous therapy with acyclovir and foscarnet. PCR could not iden tify any virus in the aqueous humour, but VZV is evidenced in cerebros pinal fluid. Acute retinal necrosis is now clearly defined by the Amer ican Uveitis Society, which should allow to determine its incidence an d risk factors. The infectious theory (VZV, HSV, CMV) widely prevails over the immune theory. We prefer the virus genome identification in t he aqueous humor or in the vitreous by PCR to confirm diagnosis rather than the specific antibody titration. Therapy consists in acyclovir, foscarnet and ganciclovir. But whatever the treatment, the visual prog nosis is poor. .