PROGRESSIVE OUTER RETINAE NECROSIS (PORN) IN AIDS PATIENTS - A DIFFERENT APPEARANCE OF VARICELLA-ZOSTER RETINITIS

Retinal infections caused by the varicella-zoster virus (VZV) have bee n reported in immunocompetent and immunocompromised individuals, Two c ases of a VZV-related retinitis are described,vith the characteristic features of the recently described progressive outer retinal necrosis (PORN) syndrome, Both patients suffered from the acquired immunodefici ency syndrome (AIDS) with greatly reduced peripheral blood CD4(+) T ly mphocyte counts, and presented with macular retinitis without vitritis . The disease was bilateral in one case and unilateral in the other, T he clinical course was rapidly progressive with widespread retinal inv olvement and the development of rhegmatogenous retinal detachment with complete loss of vision in the affected eyes despite intensive intrav enous antiviral therapy, VZV DNA was identified in vitreous biopsies, by molecular techniques based on the polymerase chain reaction (PCR), in bath patients, At present, the use of very high-dose intravenous ac yclovir may be the best therapeutic option in these patients for whom the visual prognosis is poor, Intravitreal antiviral drugs could also contribute to the management of these cases.