Acute Retinal Necrosis - Vishnu Adi 2025 05 09 скачать в хорошем качестве

Acute Retinal Necrosis - Vishnu Adi 2025 05 09

In this detailed case presentation, Dr. Vishnu Adi discusses a 67-year-old woman with acute-onset hazy vision and peripheral retinal whitening, ultimately diagnosed as acute retinal necrosis (ARN). The case highlights the importance of recognizing the classic triad of ARN—vitritis, peripheral retinal necrosis, and occlusive arteriolitis—in patients who may appear otherwise immunocompetent. Dr. Adi walks through the differential diagnosis, including CMV retinitis, progressive outer retinal necrosis (PORN), toxoplasmosis, and masquerade syndromes, and emphasizes the diagnostic value of PCR testing on aqueous or vitreous samples. The presentation also explains the phases of ARN, typical imaging findings, and how to distinguish ARN from PORN and CMV based on clinical and imaging features. Management pearls include the urgent initiation of systemic and intravitreal antivirals, careful use of corticosteroids, and the importance of long-term antiviral suppression to prevent bilateral involvement. The presentation concludes with a discussion of common complications, such as retinal detachment, optic atrophy, and PVR, and the need for vigilant follow-up. A must-watch for ophthalmologists and retina trainees managing infectious uveitis and necrotizing retinopathies.