DETECTION OF INTRAOCULAR ANTIBODY-PRODUCTION TO HERPESVIRUSES IN ACUTE RETINAL NECROSIS SYNDROME

In order to improve the determination of the causative agent in acute retinal necrosis syndrome, we evaluated the detection of intraocular a ntibody production to herpesviruses in 28 patients with this disease. Intraocular antibody production was determined by calculation of the G oldmann-Witmer coefficient whereby specific antibody titers in the inf lamed eye and circulation are related to the total IgG content in ocul ar fluid and serum. Specific antibody titers to herpesviruses and Toxo plasma were determined by the indirect immunofluorescence technique. T hirty-five patients with ocular toxoplasmosis, cataract, or proliferat ive vitreoretinal disorders were tested as controls. By this technique , intraocular antibody production to varicella tester virus or herpes simplex virus could be established in 16 (57%) of the patients with th e typical clinical features of acute retinal necrosis, compared to non e of the controls. Of the 33 affected eyes, 21 (64%) had a visual outc ome of less than 20/200. We concluded that detection of intraocular an tibody production to herpesviruses may be a useful diagnostic tool in establishing the causative agents in acute retinal necrosis.