Development of Acute Retinal Necrosis in a Patient with Ocular Sarcoidosis: A Case Report

ABSTRACT

Purpose: To report a case of acute retinal necrosis (ARN) caused by varicella-zoster virus (VZV) in an elderly patient with ocular sarcoidosis after oral corticosteroid indication.

Methods: Retrospective case report.

Results: A 75-year-old male with a past history of ocular sarcoidosis came with blurred left vision. Ocular findings in the left eye were consistent with ocular sarcoidosis, while no inflammation in the right eye. On day 14, intraocular inflammation in the left eye resolved by topical corticosteroid, but inflammatory cells were found in the right eye. Suspecting recurrence of ocular sarcoidosis, systemic corticosteroid was initiated. On day 21, inflammation worsened, and the presence of extended yellowish white peripheral retinal lesion in the right eye suggested ARN. Polymerase chain reaction (PCR) testing using ocular fluid detected 3.0 × 107 copies/ml of VZV DNA.

Conclusions: In the case of poor response to immunosuppressive therapy in elderly uveitis, infection including ARN should be considered. Immediate PCR testing for pathogen screening is required.

Keywords:

• Acute retinal necrosis
• corticosteroid
• immunosuppressive
• sarcoidosis
• varicella-zoster virus

ACKNOWLEDGMENTS

We thank the patient for granting permission to publish this report.

DECLARATION OF INTEREST

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

Additional information

Funding

This work was supported by the Grant-in-Aid for Scientific Research C (M. T.: 16K11337) and the Grant-in-Aid for Young Scientists B (K.T.: 17K16964) from the Japan Society for the Promotion of Science and by the Japan Foundation for Applied Enzymology (K.T.). The funding sources did not have any influence on the design, performance, or writing of this scientific project and paper or decision to submit it to Infection.