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Delayed acute retinal necrosis after herpetic encephalitis
  1. C E PAVÉSIO,
  2. D K CONRAD,
  3. P J McCLUSKEY,
  4. S M MITCHELL,
  5. H M A TOWLER,
  6. S LIGHTMAN
  1. Department of Clinical Ophthalmology
  2. Moorfields Eye Hospital, Institute of Ophthalmology
  3. City Road, London EC1V 2PD
  1. Professor S Lightman, Department of Clinical Ophthalmology, Moorfields Eye Hospital, City Road, London EC1V 2PD.

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Editor,—The herpes virus family, especially herpes simplex virus (HSV) and varicella zoster virus (VZV), has been associated with acute retinal necrosis (ARN)1 2 and these viruses also represent an important cause of encephalitis.3 Cases of retinitis in patients with a history of previous herpetic encephalitis, although rare, have been reported4 5; a delay between the diagnosis of encephalitis and the onset of ocular symptoms has been reported to be as long as from 1 to 5 months,6 7 but an interval of up to 5 years has been recorded.8 We report here two patients who developed the clinical picture of ARN 7 and 17 years after having had herpetic encephalitis.

CASE REPORTS

Case 1

CH, a 27-year-old white woman presented with a 10 day history of deterioration of vision in her left eye. Seven years previously she had been diagnosed as having HSV encephalitis, confirmed by electron microscopy and viral culture of a brain biopsy specimen. The sequelae of HSV encephalitis included right homonymous hemianopia. Visual acuities were 6/5 right eye and light perception left eye. The right eye …

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