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Bilateral Acute Retinal Necrosis: Clinical and Ultrastructural Study

Bilateral Acute Retinal Necrosis: Clinical and Ultrastructural Study Abstract • In a 28-year-old man with bilateral acute retinal necrosis, a severe, bilateral panuveitis, necrotizing retinitis, and retinal vasculitis developed. Severe vitreous traction on atrophic retina resulted in bilateral giant retinal tears with an inoperable retinal detachment in the right eye. A retinal detachment developed in the left eye that was reattached after a pars plana vitrectomy and two scleral buckling procedures, but ultimately became inoperable. Large numbers of lymphocytes in the vitreous aspirate and depressed serum complement levels may indicate that an immune mechanism was involved in the necrotizing retinitis. We present the first electron microscopic evidence, to our knowledge, that preretinal membranes occurring in rhegmatogenous retinal detachment due to bilateral acute retinal necrosis arise from retinal pigment epithelium. References 1. Urayama A, Yamada N, Sasaki T, et al: Unilateral acute uveitis with retinal periarteritis and detachment . Rinsho Ganka 1971;25:607-619. 2. Willerson D, Aaberg TM, Reeser FH: Necrotizing vaso-occlusive retinitis . Am J Ophthalmol 1977;84:209-219. 3. Young NJA, Bird AC: Bilateral acute retinal necrosis . Br J Ophthalmol 1978;62:581-590.Crossref 4. Price FW, Schlaegel TF: Bilateral acute retinal necrosis . Am J Ophthalmol 1980;89:419-424. 5. Mamo JG: The rate of visual loss in Behçet's disease . Arch Ophthalmol 1970;84:451-452.Crossref 6. Mamo JG, Baghdassarian A: Behçet's disease: A report of 28 cases . Arch Ophthalmol 1964;71:4-14.Crossref 7. Sigel N, Larson R: Behçet's syndrome: A case with benign pericarditis and recurrent neurologic involvement treated with adrenal steroids . Arch Intern Med 1965;115:203-207.Crossref 8. Lehner T: Behçet's syndrome and autoimmunity . Br Med J 1967;1:465-467.Crossref 9. Shimizu K: Fluorescein fundus angiography in Behçet's syndrome . Mod Probl Ophthalmol 1972;10:224-228. 10. Shikano S, Shimizu K: Atlas of Fluorescein Fundus Angiography . Philadelphia, WB Saunders Co, 1968, p 136. 11. Chajek T, Fainaru M: Behçet's disease: Report of 41 cases and a review of the literature . Medicine 1975;54:179-196.Crossref 12. Sezer FN: The isolation of a virus as the cause of Behçet's disease . Am J Ophthalmol 1953;36:301-315. 13. Mamo JG: Treatment of Behçet disease with chlorambucil: A follow-up report . Arch Ophthalmol 1976;94:580-583.Crossref 14. Abdalla MI, Bahgat N El-D: Long-lasting remission of Behçet's disease after chlorambucil therapy Br J Ophthalmol 1973:57;706-711.Crossref 15. Mamo JG, Azzam SA: Treatment of Behçet's disease with chlorambucil . Arch Ophthalmol 1970;84:446-450.Crossref 16. Godfrey WA, Epstein WV, O'Connor GR, et al: The use of chlorambucil in intractable idiopathic uveitis . Am J Ophthalmol 1974;78:415-428. 17. Tricoulis DIM: Treatment of Behçet's disease with chlorambucil . Br J Ophthalmol 1976;60:55-57.Crossref 18. Wong VG: Immunosuppressive therapy of ocular inflammatory diseases . Arch Ophthalmol 1969;81:628-637.Crossref 19. Wise GN, Dollery CT, Henkind P: Retinal Circulation . New York, Harper & Row Publishers Inc, 1971, pp 293-297. 20. Amalric P: Acute choroidal ischaemia . Trans Ophthalmol Soc UK 1971;91:305-324. 21. Foulds WS, Lee WR, Taylor WOG: Clinical and pathological aspects of choroidal ischaemia . Trans Ophthalmol Soc UK 1971;91:325-343. 22. Henkind P: Ischaemia of the posterior pole . Trans Ophthalmol Soc UK 1971;91:345-356. 23. Weinreb RN, Barth R, Kimura SJ: Limited gallium scans and angiotensin converting enzyme in granulomatous uveitis . Ophthalmology 1980;87:202-209.Crossref 24. Nelson DA, Weiner A, Yanoff M, et al: Retinal lesions in subacute sclerosing panencephalitis . Arch Ophthalmol 1970;84:613-621.Crossref 25. Cibis GW: Neonatal herpes simplex retinitis . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1975;196:39-47.Crossref 26. Cogan DG, Kuwabara T, Young GF, et al: Herpes simplex retinopathy in an infant . Arch Ophthalmol 1964;72:641-645.Crossref 27. Cogan DG: Immunosuppression and eye disease . Am J Ophthalmol 1977;83:777-788. 28. Nahmias AJ, Hagler WS: Ocular manifestations of herpes simplex in the newborn (neonatal ocular herpes) . Int Ophthalmol Clin 1972;12:191-213. 29. Hagler WS, Walters PV, Nahmias AJ: Ocular involvement in neonatal herpes simplex virus infection . Arch Ophthalmol 1969;82:169-176.Crossref 30. Chumbley LC, Robertson DM, Smith TF, et al: Adult cytomegalovirus inclusion retino-uveitis . Am J Ophthalmol 1975;80:807-816. 31. DeVenecia G, zuRhein GM, Pratt MV, et al: Cytomegalic inclusion retinitis in an adult . Arch Ophthalmol 1971;86:44-57.Crossref 32. Aaberg TM, Cesarz TJ, Rytel MW: Correlation of virology and clinical course of cytomegalovirus retinitis . Am J Ophthalmol 1972;74:407-415. 33. Meredith TA, Aaberg TM, Reeser FH: Rhegmatogenous retinal detachment complicating cytomegalovirus retinitis . Am J Ophthalmol 1979;87:793-796. 34. Porter R: Acute necrotizing retinitis in a patient receiving immunosuppressive therapy . Br J Ophthalmol 1972;56:555-558.Crossref 35. Wyhinny GJ, Apple DJ, Guastella FR, et al: Adult cytomegalic inclusion retinitis . Am J Ophthalmol 1973;76:773-781. 36. Merritt JC, Callender CO: Adult cytomegalic inclusion retinitis . Ann Ophthalmol 1978;10:1059-1063. 37. Mills PV: Ocular cytomegalic inclusion disease in the adult . Trans Ophthalmol Soc UK 1977;97:501-504. 38. Broughton WL, Cupples HP, Parver LM: Bilateral retinal detachment following cytomegalovirus retinitis . Arch Ophthalmol 1978;96:618-619.Crossref 39. Smith ME: Retinal involvement in adult cytomegalic inclusion disease . Arch Ophthalmol 1964;72:44-49.Crossref 40. Cox F, Meyer D, Hughes WT: Cytomegalovirus in tears from patients with normal eyes and with acute cytomegalovirus chorioretinitis . Am J Ophthalmol 1975;80:817-824. 41. Diddie KR, Schanzlin DJ, Mausolf FA, et al: Necrotizing retinitis caused by opportunistic virus infection in a patient with Hodgkin's disease . Am J Ophthalmol 1979;88:668-673. 42. Wallow I: Nektrotisierende retinitis bei schwerer allgemeinerkrankung . Ber Dtsch Ophthalmol Ges 1970;70:55-58. 43. Brown RM, Mendis U: Retinal arteritis complicating herpes zoster ophthalmicus . Br J Ophthalmol 1973;57:344-346.Crossref 44. Chawla HB, Ford MJ, Munro JF, et al: Ocular involvement in cytomegalovirus infection in a previously healthy adult . Br Med J 1976;2:281-282.Crossref 45. Minckler DS, McLean EB, Shaw CM, et al: Herpes virus hominis encephalitis and retinitis . Arch Ophthalmol 1976;94:89-95.Crossref 46. Johnson BL, Wisotzkey HM: Neuroretinitis associated with herpes simplex encephalitis in an adult . Am J Ophthalmol 1977;83:481-489. 47. Pavan-Langston D, Brockhurst RJ: Herpes simplex panuveitis . Arch Ophthalmol 1969;81:783-787.Crossref 48. Naumann G, Gass JDM, Font RL: Histopathology of herpes zoster ophthalmicus . Am J Ophthalmol 1968;65:533-541. 49. Cohen C, Luntz MH: Rift-Valley-Fieber und rickettsianretinitis einschliesslich fluoresceinangiographie . Klin Monatsbl Augenheilkd 1976;169:685-699. 50. Michelson JB, Shields JA, McDonald PR, et al: Retinitis secondary to acquired systemic toxoplasmosis with isolation of the parasite . Am J Ophthalmol 1978;86:548-552. 51. Hagler WS, Jarrett WH, Chang M: Rhegmatogenous retinal detachment following chorioretinal inflammatory disease . Am J Ophthalmol 1978;86:373-379. 52. Von Sallmann L, Meyers RE, Stone SH, et al: Retinal and uveal inflammation in monkeys following inoculation with homologous retinal antigen . Arch Ophthalmol 1969;81:374-382.Crossref 53. DeKozak Y, Thillaye B, Renard G, et al: Hyperacute form of experimental autoimmune uveo-retinitis in Lewis rats; electron microscopic study . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1978;208:135-142.Crossref 54. Green WR, Kenyon KR, Michels RG, et al: Ultrastructure of epiretinal membranes causing macular pucker after retinal re-attachment surgery . Trans Ophthalmol Soc UK 1979;99:63-77. 55. Machemer R, Van Horn D, Aaberg TM: Pigment epithelial proliferation in human retinal detachment . Am J Ophthalmol 1978;85:181-191. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Bilateral Acute Retinal Necrosis: Clinical and Ultrastructural Study

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1982.01030040881002
Publisher site
See Article on Publisher Site

Abstract

Abstract • In a 28-year-old man with bilateral acute retinal necrosis, a severe, bilateral panuveitis, necrotizing retinitis, and retinal vasculitis developed. Severe vitreous traction on atrophic retina resulted in bilateral giant retinal tears with an inoperable retinal detachment in the right eye. A retinal detachment developed in the left eye that was reattached after a pars plana vitrectomy and two scleral buckling procedures, but ultimately became inoperable. Large numbers of lymphocytes in the vitreous aspirate and depressed serum complement levels may indicate that an immune mechanism was involved in the necrotizing retinitis. We present the first electron microscopic evidence, to our knowledge, that preretinal membranes occurring in rhegmatogenous retinal detachment due to bilateral acute retinal necrosis arise from retinal pigment epithelium. References 1. Urayama A, Yamada N, Sasaki T, et al: Unilateral acute uveitis with retinal periarteritis and detachment . Rinsho Ganka 1971;25:607-619. 2. Willerson D, Aaberg TM, Reeser FH: Necrotizing vaso-occlusive retinitis . Am J Ophthalmol 1977;84:209-219. 3. Young NJA, Bird AC: Bilateral acute retinal necrosis . Br J Ophthalmol 1978;62:581-590.Crossref 4. Price FW, Schlaegel TF: Bilateral acute retinal necrosis . Am J Ophthalmol 1980;89:419-424. 5. Mamo JG: The rate of visual loss in Behçet's disease . Arch Ophthalmol 1970;84:451-452.Crossref 6. Mamo JG, Baghdassarian A: Behçet's disease: A report of 28 cases . Arch Ophthalmol 1964;71:4-14.Crossref 7. Sigel N, Larson R: Behçet's syndrome: A case with benign pericarditis and recurrent neurologic involvement treated with adrenal steroids . Arch Intern Med 1965;115:203-207.Crossref 8. Lehner T: Behçet's syndrome and autoimmunity . Br Med J 1967;1:465-467.Crossref 9. Shimizu K: Fluorescein fundus angiography in Behçet's syndrome . Mod Probl Ophthalmol 1972;10:224-228. 10. Shikano S, Shimizu K: Atlas of Fluorescein Fundus Angiography . Philadelphia, WB Saunders Co, 1968, p 136. 11. Chajek T, Fainaru M: Behçet's disease: Report of 41 cases and a review of the literature . Medicine 1975;54:179-196.Crossref 12. Sezer FN: The isolation of a virus as the cause of Behçet's disease . Am J Ophthalmol 1953;36:301-315. 13. Mamo JG: Treatment of Behçet disease with chlorambucil: A follow-up report . Arch Ophthalmol 1976;94:580-583.Crossref 14. Abdalla MI, Bahgat N El-D: Long-lasting remission of Behçet's disease after chlorambucil therapy Br J Ophthalmol 1973:57;706-711.Crossref 15. Mamo JG, Azzam SA: Treatment of Behçet's disease with chlorambucil . Arch Ophthalmol 1970;84:446-450.Crossref 16. Godfrey WA, Epstein WV, O'Connor GR, et al: The use of chlorambucil in intractable idiopathic uveitis . Am J Ophthalmol 1974;78:415-428. 17. Tricoulis DIM: Treatment of Behçet's disease with chlorambucil . Br J Ophthalmol 1976;60:55-57.Crossref 18. Wong VG: Immunosuppressive therapy of ocular inflammatory diseases . Arch Ophthalmol 1969;81:628-637.Crossref 19. Wise GN, Dollery CT, Henkind P: Retinal Circulation . New York, Harper & Row Publishers Inc, 1971, pp 293-297. 20. Amalric P: Acute choroidal ischaemia . Trans Ophthalmol Soc UK 1971;91:305-324. 21. Foulds WS, Lee WR, Taylor WOG: Clinical and pathological aspects of choroidal ischaemia . Trans Ophthalmol Soc UK 1971;91:325-343. 22. Henkind P: Ischaemia of the posterior pole . Trans Ophthalmol Soc UK 1971;91:345-356. 23. Weinreb RN, Barth R, Kimura SJ: Limited gallium scans and angiotensin converting enzyme in granulomatous uveitis . Ophthalmology 1980;87:202-209.Crossref 24. Nelson DA, Weiner A, Yanoff M, et al: Retinal lesions in subacute sclerosing panencephalitis . Arch Ophthalmol 1970;84:613-621.Crossref 25. Cibis GW: Neonatal herpes simplex retinitis . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1975;196:39-47.Crossref 26. Cogan DG, Kuwabara T, Young GF, et al: Herpes simplex retinopathy in an infant . Arch Ophthalmol 1964;72:641-645.Crossref 27. Cogan DG: Immunosuppression and eye disease . Am J Ophthalmol 1977;83:777-788. 28. Nahmias AJ, Hagler WS: Ocular manifestations of herpes simplex in the newborn (neonatal ocular herpes) . Int Ophthalmol Clin 1972;12:191-213. 29. Hagler WS, Walters PV, Nahmias AJ: Ocular involvement in neonatal herpes simplex virus infection . Arch Ophthalmol 1969;82:169-176.Crossref 30. Chumbley LC, Robertson DM, Smith TF, et al: Adult cytomegalovirus inclusion retino-uveitis . Am J Ophthalmol 1975;80:807-816. 31. DeVenecia G, zuRhein GM, Pratt MV, et al: Cytomegalic inclusion retinitis in an adult . Arch Ophthalmol 1971;86:44-57.Crossref 32. Aaberg TM, Cesarz TJ, Rytel MW: Correlation of virology and clinical course of cytomegalovirus retinitis . Am J Ophthalmol 1972;74:407-415. 33. Meredith TA, Aaberg TM, Reeser FH: Rhegmatogenous retinal detachment complicating cytomegalovirus retinitis . Am J Ophthalmol 1979;87:793-796. 34. Porter R: Acute necrotizing retinitis in a patient receiving immunosuppressive therapy . Br J Ophthalmol 1972;56:555-558.Crossref 35. Wyhinny GJ, Apple DJ, Guastella FR, et al: Adult cytomegalic inclusion retinitis . Am J Ophthalmol 1973;76:773-781. 36. Merritt JC, Callender CO: Adult cytomegalic inclusion retinitis . Ann Ophthalmol 1978;10:1059-1063. 37. Mills PV: Ocular cytomegalic inclusion disease in the adult . Trans Ophthalmol Soc UK 1977;97:501-504. 38. Broughton WL, Cupples HP, Parver LM: Bilateral retinal detachment following cytomegalovirus retinitis . Arch Ophthalmol 1978;96:618-619.Crossref 39. Smith ME: Retinal involvement in adult cytomegalic inclusion disease . Arch Ophthalmol 1964;72:44-49.Crossref 40. Cox F, Meyer D, Hughes WT: Cytomegalovirus in tears from patients with normal eyes and with acute cytomegalovirus chorioretinitis . Am J Ophthalmol 1975;80:817-824. 41. Diddie KR, Schanzlin DJ, Mausolf FA, et al: Necrotizing retinitis caused by opportunistic virus infection in a patient with Hodgkin's disease . Am J Ophthalmol 1979;88:668-673. 42. Wallow I: Nektrotisierende retinitis bei schwerer allgemeinerkrankung . Ber Dtsch Ophthalmol Ges 1970;70:55-58. 43. Brown RM, Mendis U: Retinal arteritis complicating herpes zoster ophthalmicus . Br J Ophthalmol 1973;57:344-346.Crossref 44. Chawla HB, Ford MJ, Munro JF, et al: Ocular involvement in cytomegalovirus infection in a previously healthy adult . Br Med J 1976;2:281-282.Crossref 45. Minckler DS, McLean EB, Shaw CM, et al: Herpes virus hominis encephalitis and retinitis . Arch Ophthalmol 1976;94:89-95.Crossref 46. Johnson BL, Wisotzkey HM: Neuroretinitis associated with herpes simplex encephalitis in an adult . Am J Ophthalmol 1977;83:481-489. 47. Pavan-Langston D, Brockhurst RJ: Herpes simplex panuveitis . Arch Ophthalmol 1969;81:783-787.Crossref 48. Naumann G, Gass JDM, Font RL: Histopathology of herpes zoster ophthalmicus . Am J Ophthalmol 1968;65:533-541. 49. Cohen C, Luntz MH: Rift-Valley-Fieber und rickettsianretinitis einschliesslich fluoresceinangiographie . Klin Monatsbl Augenheilkd 1976;169:685-699. 50. Michelson JB, Shields JA, McDonald PR, et al: Retinitis secondary to acquired systemic toxoplasmosis with isolation of the parasite . Am J Ophthalmol 1978;86:548-552. 51. Hagler WS, Jarrett WH, Chang M: Rhegmatogenous retinal detachment following chorioretinal inflammatory disease . Am J Ophthalmol 1978;86:373-379. 52. Von Sallmann L, Meyers RE, Stone SH, et al: Retinal and uveal inflammation in monkeys following inoculation with homologous retinal antigen . Arch Ophthalmol 1969;81:374-382.Crossref 53. DeKozak Y, Thillaye B, Renard G, et al: Hyperacute form of experimental autoimmune uveo-retinitis in Lewis rats; electron microscopic study . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1978;208:135-142.Crossref 54. Green WR, Kenyon KR, Michels RG, et al: Ultrastructure of epiretinal membranes causing macular pucker after retinal re-attachment surgery . Trans Ophthalmol Soc UK 1979;99:63-77. 55. Machemer R, Van Horn D, Aaberg TM: Pigment epithelial proliferation in human retinal detachment . Am J Ophthalmol 1978;85:181-191.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Dec 1, 1982

References