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Editor,—The progressive retinal outer necrosis syndrome (PORN) is a recognised variant of necrotising herpetic retinopathy, presumably caused by the varicella zoster virus.1 2 The syndrome is characterised by minimal intraocular inflammation, rapidly spreading multifocal deep retinal lesions without vascular involvement (until late in the disease), bilateral involvement in the majority of the cases, and poor visual prognosis irrespective of treatment.2 So far, the majority of the described cases were related to HIV disease. We present a HIV seronegative immunocompromised patient with normal CD4 counts, who developed PORN and responded well to aciclovir.
CASE REPORT
A 29 year old man with cutaneous non-Hodgkin’s T cell lymphoma (Sézary syndrome) for 4 years, developed a progressive loss of vision of his right eye within 5 days. Five weeks previously, he had had a thoracic zoster that responded well to orally administered aciclovir (5 × 800 mg per day). On admission, the visual acuity of the …