Skip to main content

Herpes Viral Retinochoroiditis

  • Living reference work entry
  • First Online:
Book cover The Uveitis Atlas

Abstract

Few viruses have a particular affinity for the retina, can infect it and cause superficial or deep necrotic lesions, both in immunosuppressed and immunocompetent patients. Among various clinical situations, acute retinal necrosis or ARN syndrome is a well-defined condition, due to a member of the herpesvirus family, presenting with vitritis, retinal necrosis, severe retinal occlusive vasculitis, and papillitis. Like other herpetic retinopathies, ARN is a diagnosic and therapeutic emergency, but it is not always possible to prevent the occurrence of serious complications such as retinal detachment and final poor visual outcome despite aggressive antiviral therapy. Molecular diagnosis is playing a major role in viral identification and monitoring of treatment efficacy. Some viral retinal disorders may be difficult to differentiate from those caused by nonviral infectious agents such as syphilis and toxoplasmic retinochoroiditis or a malignant condition.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Suggested Reading

  • Aizman A, Johnson MW, Elner SG. Treatment of acute retinal necrosis syndrome with oral antiviral medications. Ophthalmology. 2007;114:307–12.

    Article  PubMed  Google Scholar 

  • Almeida DR, Chin EK, Tarantola RM, et al. Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis. Clin Ophthalmol Auckl NZ. 2015;9:1307–14.

    Google Scholar 

  • Atherton SS. Acute retinal necrosis: insights into pathogenesis from the mouse model. Herpes J IHMF. 2001;8:69–73.

    CAS  Google Scholar 

  • Azumi A, Cousins SW, Kanter MY, Atherton SS. Modulation of murine herpes simplex virus type 1 retinitis in the uninoculated eye by CD4+ T lymphocytes. Invest Ophthalmol Vis Sci. 1994;35:54–63.

    CAS  PubMed  Google Scholar 

  • Balansard B, Bodaghi B, Cassoux N, et al. Necrotising retinopathies simulating acute retinal necrosis syndrome. Br J Ophthalmol. 2005;89:96–101.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bodaghi B, Le Hoang P. Uvéite. Paris: Elsevier; 2009. 394 p.

    Google Scholar 

  • Bodaghi B, Rozenberg F, Cassoux N, Fardeau C, LeHoang P. Nonnecrotizing herpetic retinopathies masquerading as severe posterior uveitis. Ophthalmology. 2003;110:1737–43.

    Article  PubMed  Google Scholar 

  • Culbertson WW, Blumenkranz MS, Haines H, Gass DM, Mitchell KB, Norton EW. The acute retinal necrosis syndrome. Part 2: histopathology and etiology. Ophthalmology. 1982;89:1317–25.

    Article  CAS  PubMed  Google Scholar 

  • Culbertson WW, Blumenkranz MS, Pepose JS, Stewart JA, Curtin VT. Varicella zoster virus is a cause of the acute retinal necrosis syndrome. Ophthalmology. 1986;93:559–69.

    Article  CAS  PubMed  Google Scholar 

  • Cunningham ET, Wong RW, Takakura A, Downes KM, Zierhut M. Necrotizing herpetic retinitis. Ocul Immunol Inflamm. 2014;22:167–9.

    Article  PubMed  Google Scholar 

  • Emerson GG, Smith JR, Wilson DJ, Rosenbaum JT, Flaxel CJ. Primary treatment of acute retinal necrosis with oral antiviral therapy. Ophthalmology. 2006;113:2259–61.

    Article  PubMed  Google Scholar 

  • Figueroa MS, Garabito I, Gutierrez C, Fortun J. Famciclovir for the treatment of acute retinal necrosis (ARN) syndrome. Am J Ophthalmol. 1997;123:255–7.

    Article  CAS  PubMed  Google Scholar 

  • Han DP, Lewis H, Williams GA, Mieler WF, Abrams GW, Aaberg TM. Laser photocoagulation in the acute retinal necrosis syndrome. Arch Ophthalmol Chic Ill 1960. 1987;105:1051–4.

    Article  CAS  Google Scholar 

  • Holland GN. Standard diagnostic criteria for the acute retinal necrosis syndrome. Executive committee of the American uveitis society. Am J Ophthalmol. 1994;117:663–7.

    Article  CAS  PubMed  Google Scholar 

  • Iwahashi-Shima C, Azumi A, Ohguro N, et al. Acute retinal necrosis: factors associated with anatomic and visual outcomes. Jpn J Ophthalmol. 2013;57:98–103.

    Article  PubMed  Google Scholar 

  • Knox CM, Chandler D, Short GA, Margolis TP. Polymerase chain reaction-based assays of vitreous samples for the diagnosis of viral retinitis. Use in diagnostic dilemmas. Ophthalmology. 1998;105:37–44, 45.

    Google Scholar 

  • Kuo A, Ziaee SM, Hosseini H, et al. The great imitator: ocular syphilis presenting as posterior uveitis. Am J Case Rep. 2015;16:434–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • La Cava M, Abbouda A, Restivo L, Zito R. Delayed onset of bilateral acute retinal necrosis syndrome: a 46-year interval. Semin Ophthalmol. 2015;30:146–9.

    Article  PubMed  Google Scholar 

  • Labetoulle M, Kucera P, Ugolini G, et al. Neuronal pathways for the propagation of herpes simplex virus type 1 from one retina to the other in a murine model. J Gen Virol. 2000;81:1201–10.

    Article  CAS  PubMed  Google Scholar 

  • Lau CH, Missotten T, Salzmann J, Lightman SL. Acute retinal necrosis features, management, and outcomes. Ophthalmology. 2007;114:756–62.

    Article  PubMed  Google Scholar 

  • Matsubara S, Atherton SS. Spread of HSV-1 to the suprachiasmatic nuclei and retina in T cell depleted BALB/c mice. J Neuroimmunol. 1997;80:165–71.

    Article  CAS  PubMed  Google Scholar 

  • McDonald HR, Lewis H, Kreiger AE, Sidikaro Y, Heckenlively J. Surgical management of retinal detachment associated with the acute retinal necrosis syndrome. Br J Ophthalmol. 1991;75:455–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Muthiah MN, Michaelides M, Child CS, Mitchell SM. Acute retinal necrosis: a national population-based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK. Br J Ophthalmol. 2007;91:1452–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ohtake-Matsumoto A, Keino H, Koto T, Okada AA. Spectral domain and swept source optical coherence tomography findings in acute retinal necrosis. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Für Klin Exp Ophthalmol. 2015;253:2049–51.

    Article  Google Scholar 

  • Raymond LA, Wilson CA, Linnemann CC, Ward MA, Bernstein DI, Love DC. Punctate outer retinitis in acute Epstein-Barr virus infection. Am J Ophthalmol. 1987;104:424–6.

    Article  CAS  PubMed  Google Scholar 

  • Reddy AK. Peripheral vascular occlusion in acute retinal necrosis. JAMA Ophthalmol. 2015;133:e152157.

    Article  PubMed  Google Scholar 

  • Roy R, Pal BP, Mathur G, Rao C, Das D, Biswas J. Acute retinal necrosis: clinical features, management and outcomes – a 10 year consecutive case series. Ocul Immunol Inflamm. 2014;22:170–4.

    Article  PubMed  Google Scholar 

  • Smith LK, Kurz PA, Wilson DJ, Flaxel CJ, Rosenbaum JT. Two patients with the von Szily reaction: herpetic keratitis and contralateral retinal necrosis. Am J Ophthalmol. 2007;143:536–8.

    Article  PubMed  Google Scholar 

  • Takase H, Okada AA, Goto H, et al. Development and validation of new diagnostic criteria for acute retinal necrosis. Jpn J Ophthalmol. 2015;59:14–20.

    Article  CAS  PubMed  Google Scholar 

  • Tibbetts MD, Shah CP, Young LH, Duker JS, Maguire JI, Morley MG. Treatment of acute retinal necrosis. Ophthalmology. 2010;117:818–24.

    Article  PubMed  Google Scholar 

  • Tiedeman JS. Epstein-Barr viral antibodies in multifocal choroiditis and panuveitis. Am J Ophthalmol. 1987;103:659–63.

    Article  CAS  PubMed  Google Scholar 

  • Tran THC, Rozenberg F, Cassoux N, Rao NA, LeHoang P, Bodaghi B. Polymerase chain reaction analysis of aqueous humour samples in necrotising retinitis. Br J Ophthalmol. 2003;87:79–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tran THC, Stanescu D, Caspers-Velu L, et al. Clinical characteristics of acute HSV-2 retinal necrosis. Am J Ophthalmol. 2004;137:872–9.

    Article  PubMed  Google Scholar 

  • Usui Y, Takeuchi M, Goto H, et al. Acute retinal necrosis in Japan. Ophthalmology. 2008;115:1632–3.

    Article  PubMed  Google Scholar 

  • Ward TS, Reddy AK. Fundus autofluorescence in the diagnosis and monitoring of acute retinal necrosis. J Ophthalmic Inflamm Infect. 2015;5:19.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wensing B, de Groot-Mijnes JDF, Rothova A. Necrotizing and nonnecrotizing variants of herpetic uveitis with posterior segment involvement. Arch Ophthalmol Chic Ill 1960. 2011;129:403–8.

    Article  Google Scholar 

  • Winterhalter S, Stuebiger N, Maier A-K, et al. Acute retinal necrosis: diagnostic and treatment strategies in Germany. Ocul Immunol Inflamm. 2016;24(5):537–43.

    Google Scholar 

  • Wong R, Pavesio CE, Laidlaw DAH, Williamson TH, Graham EM, Stanford MR. Acute retinal necrosis: the effects of intravitreal foscarnet and virus type on outcome. Ophthalmology. 2010;117:556–60.

    Article  PubMed  Google Scholar 

  • Wong RW, Jumper JM, McDonald HR, et al. Emerging concepts in the management of acute retinal necrosis. Br J Ophthalmol. 2013;97:545–52.

    Article  PubMed  Google Scholar 

  • Yawn BP, Gilden D. The global epidemiology of herpes zoster. Neurology. 2013;81:928–30.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anne-Laure Rémond .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer (India) Pvt. Ltd.

About this entry

Cite this entry

Rémond, AL., Le Hoang, P., Bodaghi, B. (2016). Herpes Viral Retinochoroiditis. In: Gupta, V., Nguyen, Q., LeHoang, P., Herbort Jr., C. (eds) The Uveitis Atlas. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2506-5_54-1

Download citation

  • DOI: https://doi.org/10.1007/978-81-322-2506-5_54-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-2506-5

  • Online ISBN: 978-81-322-2506-5

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics