Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis
We report the case of a 52-year-old woman who presented to the emergency department with acute retinal necrosis in her left eye secondary to herpes simplex virus type 1 encephalitis for which she had been hospitalized four months before. Treatment with intravitreal foscarnet and intravenous acyclovi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Vision |
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| Online Access: | https://www.mdpi.com/2411-5150/6/2/27 |
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| author | Olga E. Makri Iasonas K. Tsekouras Leonidia Leonidou Konstantinos Kagkelaris Vassilios Kozobolis Constantinos D. Georgakopoulos |
| author_facet | Olga E. Makri Iasonas K. Tsekouras Leonidia Leonidou Konstantinos Kagkelaris Vassilios Kozobolis Constantinos D. Georgakopoulos |
| author_sort | Olga E. Makri |
| collection | DOAJ |
| description | We report the case of a 52-year-old woman who presented to the emergency department with acute retinal necrosis in her left eye secondary to herpes simplex virus type 1 encephalitis for which she had been hospitalized four months before. Treatment with intravitreal foscarnet and intravenous acyclovir was promptly commenced followed by the addition of oral prednisolone. PCR analysis of aqueous humor detected HSV type 1 DNA. The condition responded to therapy with partial resolution of intraocular inflammation and improvement of visual acuity, but the presence of Kyrieleis plaques was observed two weeks after the initiation of treatment, when five intravitreal foscarnet injections had been administered. The patient was switched to oral therapy with valacyclovir, and 10 weeks after commencing treatment, the patient’s left eye was free of inflammation, having achieved a BCVA of 20/20. Oral steroid treatment was gradually tapered off, and the patient was instructed to remain on prophylactic antiviral therapy. Kyrieleis arteriolitis is an uncommon finding in the context of acute retinal necrosis. As far as we are aware, we report the first case of Kyrieleis arteriolitis in acute retinal necrosis secondary to viral encephalitis and the second one presenting Kyrieleis plaques in acute retinal necrosis caused by herpes simplex virus type 1. Prior reports of cases of Kyrieleis arteriolitis in acute retinal necrosis are also presented. |
| first_indexed | 2024-03-09T22:13:27Z |
| format | Article |
| id | doaj.art-80f3ab1c2e654b3da46920d423dc7142 |
| institution | Directory Open Access Journal |
| issn | 2411-5150 |
| language | English |
| last_indexed | 2024-03-09T22:13:27Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vision |
| spelling | doaj.art-80f3ab1c2e654b3da46920d423dc71422023-11-23T19:27:59ZengMDPI AGVision2411-51502022-05-01622710.3390/vision6020027Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic EncephalitisOlga E. Makri0Iasonas K. Tsekouras1Leonidia Leonidou2Konstantinos Kagkelaris3Vassilios Kozobolis4Constantinos D. Georgakopoulos5Department of Ophthalmology, Medical School, University of Patras, 265 04 Patras, GreeceDepartment of Ophthalmology, Medical School, University of Patras, 265 04 Patras, GreeceInternal Medicine, Department of Internal Medicine, Patras University Hospital, 265 04 Patras, GreeceDepartment of Ophthalmology, Medical School, University of Patras, 265 04 Patras, GreeceDepartment of Ophthalmology, Medical School, University of Patras, 265 04 Patras, GreeceDepartment of Ophthalmology, Medical School, University of Patras, 265 04 Patras, GreeceWe report the case of a 52-year-old woman who presented to the emergency department with acute retinal necrosis in her left eye secondary to herpes simplex virus type 1 encephalitis for which she had been hospitalized four months before. Treatment with intravitreal foscarnet and intravenous acyclovir was promptly commenced followed by the addition of oral prednisolone. PCR analysis of aqueous humor detected HSV type 1 DNA. The condition responded to therapy with partial resolution of intraocular inflammation and improvement of visual acuity, but the presence of Kyrieleis plaques was observed two weeks after the initiation of treatment, when five intravitreal foscarnet injections had been administered. The patient was switched to oral therapy with valacyclovir, and 10 weeks after commencing treatment, the patient’s left eye was free of inflammation, having achieved a BCVA of 20/20. Oral steroid treatment was gradually tapered off, and the patient was instructed to remain on prophylactic antiviral therapy. Kyrieleis arteriolitis is an uncommon finding in the context of acute retinal necrosis. As far as we are aware, we report the first case of Kyrieleis arteriolitis in acute retinal necrosis secondary to viral encephalitis and the second one presenting Kyrieleis plaques in acute retinal necrosis caused by herpes simplex virus type 1. Prior reports of cases of Kyrieleis arteriolitis in acute retinal necrosis are also presented.https://www.mdpi.com/2411-5150/6/2/27acute retinal necrosisherpes simplexKyrieleisfoscarnet |
| spellingShingle | Olga E. Makri Iasonas K. Tsekouras Leonidia Leonidou Konstantinos Kagkelaris Vassilios Kozobolis Constantinos D. Georgakopoulos Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis Vision acute retinal necrosis herpes simplex Kyrieleis foscarnet |
| title | Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis |
| title_full | Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis |
| title_fullStr | Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis |
| title_full_unstemmed | Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis |
| title_short | Kyrieleis Arteriolitis Associated with Acute Retinal Necrosis Due to Herpes Simplex Virus Type 1 Secondary to Herpetic Encephalitis |
| title_sort | kyrieleis arteriolitis associated with acute retinal necrosis due to herpes simplex virus type 1 secondary to herpetic encephalitis |
| topic | acute retinal necrosis herpes simplex Kyrieleis foscarnet |
| url | https://www.mdpi.com/2411-5150/6/2/27 |
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