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60-year-old develops retinal necrosis

A man presented to a US hospital with loss of vision in his left eye two years after suffering encephalitis from a herpes simplex virus infection

06 Jun 2019 by Selina Powell

BMJ Case Reports authors have described the case of a man who was treated for retinal necrosis two years after a severe herpes simplex virus (HSV) infection caused his brain to swell.

The clinicians shared that the 60-year-old patient presented at hospital with acute visual loss in his left eye.

He reported experiencing blurry vision two days previously.

The patient had previously been hospitalised for encephalitis as a result of a HSV type 1 infection.

A dilated funduscopic examination of the left eye revealed a retinal haemorrhage, occlusive vasculitis and ischaemic change. The right eye was unremarkable.
The patient was treated with high-dose intravenous acyclovir for two weeks, followed by two weeks of high-dose oral acyclovir.

At a two-month follow up, the left eye had severe retinal scarring with a central retinal detachment. Vision was limited to light perception in the left eye.

Image credit: Pixabay

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