Rapidly progressive outer retinal necrosis in the acquired immunodeficiency syndrome

Am J Ophthalmol. 1990 Oct 15;110(4):341-8. doi: 10.1016/s0002-9394(14)77012-6.


Two patients, both seropositive for the human immunodeficiency virus, developed rapidly progressive retinal necrosis associated with a systemic herpes zoster infection. The retinitis in these patients was characterized by primary involvement of the outer retina, with sparing of the inner retina and retinal vasculature until late in the disease process; a rapidly progressive course; poor response to intravenous acyclovir; and development of rhegmatogenous retinal detachment. In one of the patients, the retinitis was initially multifocal. Electron microscopy of a retinal biopsy specimen from one of the patients demonstrated virus particles consistent with a herpesvirus, and polymerase chain reaction disclosed herpesvirus in a retinal biopsy specimen of the other patient. This entity may represent a distinct form of acute retinal necrosis that is seen in immunocompromised individuals.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Adult
  • Fluorescein Angiography
  • Fundus Oculi
  • HIV Seropositivity / complications
  • Herpes Zoster Ophthalmicus / complications
  • Humans
  • Male
  • Microscopy, Electron
  • Retina / pathology
  • Retina / ultrastructure
  • Retinal Necrosis Syndrome, Acute / complications*
  • Retinal Necrosis Syndrome, Acute / pathology