Progressive outer retinal necrosis syndrome in a lymphoma patient with good visual outcome

PURPOSE: To report: an HIV-negative lymphoma patient who developed progress ive outer retinal necrosis syndrome and who had a good visual outcome after treatment. with two-drug antiviral therapy and intravenous immunoglobulin. METHODS: Case report. RESULTS: A 43-year-old man with small lymphocytic lymphoma was diagnosed wi th progressive outer retinal necrosis in his left eye. Treatment was initia ted with intravenous foscarnet and ganciclovir as well as intravenous gamma globulin at a dose of 0.5 gm/kg per day for 5 days. On the second hospital day he was started on decadron 4 mg orally four rimes daily. No further pos terior retinitis progression was observed despite severe immunosuppression. Visual acuity remained stable at 20/30 with 10 months' follow-up. CONCLUSIONS: The benefit of using gammaglobulin in progressive outer retina l necrosis is unknown. Given the rapid improvement seen in this patient's r etinitis, it may be reasonable to consider the use of gammaglobulin in othe r cases of infectious retinitis in immunocompromised patients. (Am J Ophtha lmol 2001;132:111-120. (C) 2001 by Elsevier Science Inc. All rights reserve d.).