ACUTE RETINAL NECROSIS SYNDROME-ASSOCIATED WITH HERPES-SIMPLEX KERATITIS

Background: Although acute retinal necrosis (ARN) syndrome is caused b y a herpes group virus, association of herpetic keratitis with ARN syn drome is uncommon. A case of unilateral ARN syndrome with herpes simpl ex keratitis is discussed. Methods: A 40-year-old man developed unilat eral keratitis, necrotic retinitis, retinal vasculitis, vitritis, and iritis consistent with ARN syndrome 1 month after treatment for ipsila teral facial nerve palsy and auricular herpetic vesicles (Tolosa-Hunt syndrome). Impression cytologic examination of the corneal epithelial ulcer that developed concurrent with the intraocular findings and of t he aqueous humor (obtained by paracentesis) was performed. Results: Ce lls that reacted with anti-herpes simplex virus type 1 (HSV-1) antibod y were detected on impression cytology, and DNA fragments correspondin g to the HSV-1 DNA sequence were detected in the aqueous humor. Conclu sion: This case shows that ARN syndrome may, on rare occasions, be ass ociated with herpes keratitis secondary to HSV-1.