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Intravitreal ganciclovir and dexamethasone as adjunctive therapy in the management of acute retinal necrosis caused by varicella zoster virus.

Abstract
A 40-year-old man presented with a visual acuity of 20/400 in his right eye due to acute retinal necrosis involving two inferior quadrants. Diagnostic vitreous tap was positive for varicella zoster virus and he received intravitreal injections of ganciclovir (2 mg/0.1 mL) and dexamethasone (400 mcg/0.1 mL). Oral prednisone was added on day 3 and tapered over 3 months. Lesions showed pigmentation around day 5 and healed by day 9. He developed vitreous hemorrhage 5 months after presentation and was treated with 25-gauge pars plana vitrectomy combined with panretinal photocoagulation. Final follow-up at 7 months showed a visual acuity of 20/30, mild optic atrophy, narrow arteries, healed retinal lesions, and good panretinal photocoagulation. Intravitreal injections of dexamethasone and ganciclovir may have a role as an adjunctive therapy in the management of patients with acute retinal necrosis, particularly those caused by varicella zoster virus.
AuthorsKamal Kishore, Sachin Jain, Marco A Zarbin
JournalOphthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye (Ophthalmic Surg Lasers Imaging) Vol. 42 Online Pg. e87-90 (Sep 08 2011) ISSN: 1938-2375 [Electronic] United States
PMID21899249 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright 2011, SLACK Incorporated.
Chemical References
  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Dexamethasone
  • Ganciclovir
Topics
  • Adult
  • Anti-Inflammatory Agents (administration & dosage)
  • Antiviral Agents (administration & dosage)
  • Dexamethasone (administration & dosage)
  • Ganciclovir (administration & dosage)
  • Herpes Zoster Ophthalmicus (complications)
  • Herpesvirus 3, Human (isolation & purification)
  • Humans
  • Intravitreal Injections
  • Male
  • Retinal Necrosis Syndrome, Acute (drug therapy, virology)
  • Treatment Outcome

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