Epstein-Barr virus and acute retinal necrosis in a 5-year-old immunocompetent child

Abstract

Roberto Gallego-Pinazo1,2, Miguel Harto1, Jose J Garcia-Medina2,3, Inmaculada Serra1, Enrique España1, Maria D Pinazo-Duran2,41Ophthalmology Department, University Hospital, La Fe, Valencia, Spain; 2Ophthalmology Research Unit “Santiago Grisolia”, Valencia, Spain; 3Ophthalmology Department, Hospital La inmaculada, Huercal-Overa, Spain; 4Ophthalmology Department, Hospital Punta de Europa, Algeciras, SpainObjective: To describe a case of bilateral acute retinal necrosis syndrome (ARNS) in a 5-year-old boy.Method: A retrospective, interventional case is described in one child attending the pediatric ophthalmology section, complaining of sudden bilateral red eye and haze-impaired vision. A standardized ophthalmologic examination and specific serological probes supported the diagnosis of severe bilateral ARNS in an immunocompetent child.Results: The reduced visual acuity (<20/400), the ocular fundus signs (perivasculitis, thrombosis and retinal edema) and the positive immunoglobulin M anti-Epstein Barr virus serology, lead us to the ARNS definitive diagnosis. Antiviral therapy (Acyclovir; Zovirax®), ciclopentolate dilating eye drops, and antiplatelet treatment (acetil salicylic acid; Aspirin®) were administered until recovering the final visual acuity (20/40).Conclusions: The ARNS is an ocular disease with poor prognosis, which in turns may display better course when determining the etiopathogenic virus and selecting the appropriate and precocious therapy.Keywords: retinal necrosis, Epstein-Barr virus, antiviral serology, antiviral therapy