Case Reports in Ophthalmological Medicine (Jan 2022)

The Role of Early Vitrectomy in the Healing of Retinal Lesions in Progressive Outer Retinal Necrosis

  • Hamid Riazi-Esfahani,
  • Arash Mirzaei,
  • Masoud Mirghorbani,
  • Fariba Ghassemi,
  • Mohammad Zarei,
  • Elias Khalili Pour,
  • Nazanin Ebrahimiadib

DOI
https://doi.org/10.1155/2022/7636052
Journal volume & issue
Vol. 2022

Abstract

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Purpose. To report on the efficacy of early pars plana vitrectomy (PPV), silicone oil (SO) tamponade, and intravitreal ganciclovir injection in the treatment of a case with progressive outer retinal necrosis (PORN). Case Presentation. A 33-year-old man with a history of shingles on the chest skin 2.5 months ago presented with progressive vision loss in both eyes over the past 20 days. Fundus examination revealed retinal necrosis with perivascular clearance. Human immunodeficiency virus (HIV) infection was confirmed by western blot analysis. Treatment with intravenous acyclovir and intravitreal ganciclovir injections was unable to stop the progression of retinitis. Along with highly active antiretroviral therapy, the patient underwent PPV with SO tamponade and intravitreal ganciclovir injection in both eyes. A few days after surgery, retinal lesions started to improve. Conclusion. Early PPV, SO tamponade, and intravitreal ganciclovir injection may be considered an effective intervention in PORN patients with an unfavorable response to medical treatment.