26/03/2026
حالة نادرة تشخص في عيادتنا
التهاب القزحية الفايروسي
وتم انقاذ نظر المراجع باذن الله
الفحص والتشخيص الدقيق غايتنا
Acute retinal necrosis (ARN) is a rare but vision-threatening viral uveitis characterized by peripheral necrotizing retinitis, occlusive vasculitis, and prominent intraocular inflammation.
A 40-year-old male presented with a 1-week history of redness and pain in the right eye, There was no significant past ocular or systemic history.
On examination, visual acuity was 1 meter in the right eye and 6/6 in the left eye, Intraocular pressure was 15 mmHg in the right eye and 17 mmHg in the left.
Corneal sensation was reduced in the affected eye, Anterior segment examination revealed corneal keratic precipitates (Figure 01) with marked anterior chamber reaction (+3) The pupil was round, and no cataract was noted.
Posterior segment examination demonstrated dense vitritis , limiting fundus visualization, Deep yellow-white infiltrates with well-defined borders are seen at periphery ,a small area of retinal hemorrhage, look at video in the comment and fundus photo (Figure 03) .
Systemic investigations including complete blood count, erythrocyte sedimentation rate, C-reactive protein, chest X-ray, and immune status assessment were all within normal limits.
Based on clinical findings, a diagnosis of acute retinal necrosis was made.
Management
The patient was started on systemic antiviral therapy with oral Valacyclovir for 2 weeks as a loading dose, followed by maintenance therapy planned for 10–12 weeks.
After 24hr of Valacyclovir Systemic corticosteroid therapy was initiated using oral Prednisone at a dose of 60 mg daily, A gradual tapering schedule was planned after one month, based on clinical response.
Topical treatment included frequent administration of Dexamethasone ED , Cycloplegic ED were also prescribed.
The patient was closely monitored with regular follow-up visits to assess visual acuity, intraocular inflammation, and to detect potential complications such as retinal detachment.
الدكتور
حسين محمود احمد
طبيب اختصاص بورد عربي (دكتوراه)
