Intravitreal Foscarnet for the Treatment of Acyclovir-resistant Acute Retinal Necrosis Caused by Varicella Zoster Virus

Abstract

Purpose: To report of a case of acute retinal necrosis (ARN), successfully treated with intravitreal foscarnet.

Methods: Case report.

Results: A 40-year-old man diagnosed with varicella zoster virus (VZV)-induced ARN failed standard acyclovir treatment. He was treated subsequently with intravenous foscarnet, but developed acute renal failure after 1 day of treatment. All systemic anti-viral agents were discontinued, and intravitreal foscarnet was administered weekly. After 5 injections, the retinitis was dramatically improved.

Conclusions: Intravitreal foscarnet was efficacious in the treatment of acyclovir-resistant ARN caused by VZV. It may be used as the sole treatment in patients with intolerance to systemic administration.

Keywords:

• acute renal failure
• acute retinal necrosis
• acyclovir
• intravitreal foscarnet
• varicella zoster virus

ACKNOWLEDGMENT

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.