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Research Square
By Li Y, Chen W, Zhang X and 4 others.
Abstract Purpose: To report two rare cases of acute retinal necrosis (ARN) concurrent with contralateral optic neuropathy as the initial manifestation.
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Observational case reports.
Two cases of ipsilateral ARN accompanied by optic neuropathy in the contralateral eye are described. A 71-year-old male presented with a painful right eye and light perception (LP) visual acuity (VA). Funduscopic examination revealed peripheral yellowish necrosis as well as perivascular hemorrhage in the right eye, with optic disc edema and wedged peripapillary hemorrhages in the contralateral eye. Best corrected visual acuity (BCVA) was 0.1 in the left eye. Despite systemic antiviral therapy and intravitreal injection (IVI) of Ganciclovir were administered, progression of optic atrophy in the left eye remained rapid, with VA preserved to LP. The second patient was a 54-year-old male with a 360° peripheral extension of necrotizing retinitis with hemorrhagic vasculitis in the right eye. Concurrent optic disc edema and peripapillary hemorrhages were observed in the left eye on initial presentation. Conclusions and Importance: Our cases suggest that ARN can lead to ipsilateral necrotic lesions and concurrent optic neuropathy in the contralateral eye. Direct viral invasion can cause occlusion and dysfunction of the posterior ciliary arteries and choroidal vessels. Early recognition and prompt treatment of the contralateral eye may help avert severe visual loss.
This is a preprint: it has not been peer reviewed yet, and its findings may change.
Published in Research Square (preprint). The abstract is shown as published and remains the work of its authors; read the full article at the source.
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