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Acute retinal necrosis with exudative retinal detachment in a child
  1. Benish Aslam Perhiar1,
  2. MA Rehman Siddiqui1 and
  3. Shahnaz Ibrahim2
  1. 1Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
  2. 2Department of Pediatric and Child Health, Aga Khan University Hospital, Karachi, Pakistan
  1. Correspondence to Dr MA Rehman Siddiqui; rehman.siddiqui{at}


Acute retinal necrosis (ARN) is a rare ocular emergency caused mainly by viral entities. ARN may be caused by Herpes zoster virus (HZV) and Herpes simplex virus (HSV), both HSV-1 and HSV-2. ARN mostly present in 20–60 years old immunocompetent adults. A 7-year-old girl presented to the eye clinic with complaints of left eye redness noted by her mother for 2–3 days. On examination with indirect ophthalmoscopy, no hypopyon was seen in either eye. In the left eye fundus view was hazy. Ultrasound B-scan performed showed exudative retinal detachment. PCR of ocular fluid was positive for HSV-1 DNA. The patient was started on topical steroids and antibiotics and systemic antivirals. In addition, she also received intravitreal ganciclovir 4 mg/0.1 mL three times under general anaesthesia. At her last follow-up, 3 years from her presentation, her right eye examination was within normal limits, and left eye showed thick vitreous bands with a posterior vitreous detachment, and left inferotemporal retinal scarring.

  • retina
  • eye

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  • Contributors MARS and SI conceived the idea. MARS and BAP wrote the initial draft. BAP acquired and analyzed the data. MARS and BAP wrote final draft. All the authors reviewed and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.