Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challenge
This report describes a challenging case of refractory acute retinal necrosis (ARN) with peripapillary choroiditis as the initial presenting sign. Imaging studies confirmed multifocal choroidal lesions and noted the novel sign of vertical hyper-reflective strips (VHRS) in the outer nuclear layer. In...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | https://journals.lww.com/10.4103/IJO.IJO_894_24 |
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| author | Ankush Kawali Sai Bhakti Mishra Padmamalini Mahendradas Rohit Shetty |
| author_facet | Ankush Kawali Sai Bhakti Mishra Padmamalini Mahendradas Rohit Shetty |
| author_sort | Ankush Kawali |
| collection | DOAJ |
| description | This report describes a challenging case of refractory acute retinal necrosis (ARN) with peripapillary choroiditis as the initial presenting sign. Imaging studies confirmed multifocal choroidal lesions and noted the novel sign of vertical hyper-reflective strips (VHRS) in the outer nuclear layer. Initial treatment with acyclovir and valacyclovir failed, and involvement of the other eye suggested a resistant variant of varicella zoster virus. High-dose oral famciclovir therapy resulted in rapid resolution of ARN in both eyes. This case highlights the rare occurrence of choroiditis, the novel finding of VHRS, and the potential utility of high-dose oral famciclovir in treating refractory ARN. |
| format | Article |
| id | doaj-art-6e6492dc99cc4b1e9190c3ff608b276f |
| institution | Kabale University |
| issn | 0301-4738 1998-3689 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj-art-6e6492dc99cc4b1e9190c3ff608b276f2025-01-07T06:28:38ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-01-0173Suppl 1S2S610.4103/IJO.IJO_894_24Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challengeAnkush KawaliSai Bhakti MishraPadmamalini MahendradasRohit ShettyThis report describes a challenging case of refractory acute retinal necrosis (ARN) with peripapillary choroiditis as the initial presenting sign. Imaging studies confirmed multifocal choroidal lesions and noted the novel sign of vertical hyper-reflective strips (VHRS) in the outer nuclear layer. Initial treatment with acyclovir and valacyclovir failed, and involvement of the other eye suggested a resistant variant of varicella zoster virus. High-dose oral famciclovir therapy resulted in rapid resolution of ARN in both eyes. This case highlights the rare occurrence of choroiditis, the novel finding of VHRS, and the potential utility of high-dose oral famciclovir in treating refractory ARN.https://journals.lww.com/10.4103/IJO.IJO_894_24acute retinal necrosisangular sign of henle’s hyper-reflectivitychoroiditisfamcyclovirdrug-resistant zosterherpes zostervaricella zoster virusvertical hyper-reflective lesions |
| spellingShingle | Ankush Kawali Sai Bhakti Mishra Padmamalini Mahendradas Rohit Shetty Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challenge Indian Journal of Ophthalmology acute retinal necrosis angular sign of henle’s hyper-reflectivity choroiditis famcyclovir drug-resistant zoster herpes zoster varicella zoster virus vertical hyper-reflective lesions |
| title | Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challenge |
| title_full | Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challenge |
| title_fullStr | Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challenge |
| title_full_unstemmed | Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challenge |
| title_short | Refractory acute retinal necrosis presenting as peripapillary choroiditis – A diagnostic and therapeutic challenge |
| title_sort | refractory acute retinal necrosis presenting as peripapillary choroiditis a diagnostic and therapeutic challenge |
| topic | acute retinal necrosis angular sign of henle’s hyper-reflectivity choroiditis famcyclovir drug-resistant zoster herpes zoster varicella zoster virus vertical hyper-reflective lesions |
| url | https://journals.lww.com/10.4103/IJO.IJO_894_24 |
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