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Chapter 80 – Herpesvirus retinitis

Sally S Atherton,
Mei Zheng

Clinical background

Acute retinal necrosis (ARN), which was first reported by Urayama and colleagues, occurs rarely but is a potentially blinding disorder.[1] Most cases of ARN are unilateral, although approximately one-third of patients develop bilateral disease which may occur either coincident with involvement of the presenting eye, or weeks, months, or years later.[2] ARN is observed most commonly in the immunocompetent host but occasionally occurs when there is immunocompromise. Although varicella-zoster virus (VZV) was associated with the initial description of ARN, subsequently herpes simplex virus (HSV) type 1 (HSV-1), HSV type 2 (HSV-2), Epstein–Barr virus (EBV), and, very rarely, cytomegalovirus (CMV) were also implicated in its pathogenesis (Box 80.1).[3–8]A member of the herpesvirus family is presumed to be the pathogenic agent in cases in which a close (usually) temporal relationship between clinical herpetic infection and the …