Acute Retinal Necrosis Syndrome: Case Report and Literature Review

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M. Essakhi
B. Jatik
I. Er-rachiq
A. Mchachi
L. Benhmidoune
A. Chakib
R. Rachid
M. Elbelhadji


Acute retinal necrosis (ARN syndrome) is a rare syndrome; the germs involved belong to the herpes virus family. Complications include cystoid macular edema and retinal detachment, which is a frequent complication with a poor prognosis. We report the case of an immunocompetent patient with unilateral acute retinal necrosis due to VZV. The drop in visual acuity was brutal. Intravenous antiviral and anti-inflammatory therapy was initiated on an emergency basis, followed by oral maintenance therapy. The patient was complicated during this treatment by cystoid macular edema treated with retrobulbar steroids injections.  The Knowledge of this condition, which diagnosis is essentially clinical, is necessary in order to avoid the extension of retinal necrosis and to prevent the reccurrence of complications.

Acute retinal necrosis, herpes simplex virus, varicella zoster virus, macular edema.

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How to Cite
Essakhi, M., Jatik, B., Er-rachiq, I., Mchachi, A., Benhmidoune, L., Chakib, A., Rachid, R., & Elbelhadji, M. (2020). Acute Retinal Necrosis Syndrome: Case Report and Literature Review. Asian Journal of Research and Reports in Ophthalmology, 3(1), 10-15. Retrieved from
Case Study


Urayama A, Yamada N, Sasaki T, et al. Unilateral acute uveitis with retinal per- iarteritis and detachment. RinshoGanka 1971;25:607-19.

Scott D. Schoenberger, MD, Stephen J. Kim, MD, Jennifer E. Thorne, MD, PhD et al. Diagnosis and treatment of acute retinal necrosis. A Report by the American Academy of Ophthalmology. Ophthalmic Technology Assessment. 2016;11:007.

Izambarta C, Zura C, Fiandrinoa P, et al. Management of acute retinal necrosis syndrome complicated by cystoid macular edema. French Journal of Ophthalmology 2009;32.60:e1- 60.

Snyers B. Herpetic retinal necrosis. Bull SocBelgeOphtalmol. 2000;277:27-33.

Alami F, Nafizy I, Sufi G, and all. Acute retinal necrosis: About one case. Images in Ophthalmology. 2013;2:1.

Dascalu AM, Stana D, Popa-Cherecheanu A, Popa-Cherecheanu M, Serban D. Fulminant bilateral acute retinal necrosis after chickenpox–a case report. Romanian journal of ophthalmology. 2016;60(3):184.

Culbertson W, Blumenkranz WMS, Haines H, et al. The acute retinal necrosis syndrome, part 2: histopathology and etiology. Ophthalmology. 1982;89:1317-1325.

Snyers B. Herpetic retinal necrosis. Bull. Soc. Belge Ophtalmol. 2000;277:27-33.

Matsubara S, Atherton SS. Spread of HSV-1 to the suprachiasmatic nuclei andretina in T cell depleted BALB/c mice. J Neuroimmunol. 1997;80(1-2):165-71.

Menendez CM, Carr DJ. Defining nervous system susceptibility during acute and latent herpes simplex virus-1 infection. Journal of Neuroimmunology. 2017;308: 43-49.

Tran TH, Bodaghi B, Rozenberg F, and all. Diagnostic and therapeutic management of herpetic necrotizing retinitis. J Fr Ophtalmol. 2004;27:223-36.

Labetoulle M. Acute retinal necrosis syndrome. J Fr Ophtalmol. 1995;18(12): 799-818.

Archana Vasudevan, Christian Rojas-Moreno, Tushar Tarun. Acute retinal necrosis secondary to Varicella Zoster Virus. ID Cases 18. 2019;e00585.

Holland GN. Standard diagnostic criteria for the acute retinal necrosis syndrome. Executive Committee of the American Uveitis Society. Am J Ophthalmol. 1994; 117(5):663-7.

Lau CH, Missotten T, Salzmann J, and all. Acute retinal necrosis features, management, and outcomes. Ophthal-mology. 2007;114:756—62

Balansard B, Bodaghi B, Cassoux N, et al. Necrotising retinopathies simulating acute retinal necrosis syndrome. The British journal of ophthalmology. 2005;89(1):96-101.

Duker JS, Blumenkranz MS. Diagnosis and management of the acute retinalnecrosis (ARN) syndrome. Surv Ophthalmol. 1991;35(5):327-43.

Saari KM, Boke W, Manthey KF, and all. Bilateral acute retinal necrosis. Am J Ophthalmol. 1982;93(4):403-11.

Altamirano D, Rochat C, Claeys M, et al. Acute retinal necrosis: A result of immune dysfunction? Report of a case with subacute evolution and relapses in a patient with impaired cellular immunity. Ophthalmologica. 1994;208(1):49-53.

Matsuo T, Morimoto K, Matsuo N. Factors associated with poor visual outcome in acute retinal necrosis. The British journal of ophthalmology. 1991;75(8):450- 4.

Ichikawa T, Sakai J, Yamauchi Y, et al. A study of 44 patients with Kirisawa type uveitis. Nippon Ganka Gakkai Zasshi. 1997;101(3):243-7.