Jenny is a 31-year-old nurse who contracted the herpes virus several years ago. Ophthalmology 2006, 113: 2259–2261.Flaxel, C. J., Yeh, S., & Lauer, A. K. (2013). Treatment of Acute Retinal Necrosis. Acute retinal necrosis (ARN) is a viral retinal syndrome that is defined by the presence of all three signs – anterior uveitis and vitritis, occlusive vasculitis and peripheral necrosis . While there is no prevention for ARN, exposing a patient to antiviral agents in the earlier phases of the outbreak tend to decrease the duration of the active phase of the disease. Rationale: Acute retinal necrosis (ARN), which is characterized by peripheral necrotizing retinitis, severe retinal arteritis, and progressive inflammatory reaction in the vitreous and anterior chambers, has been reported in cases with herpes simplex encephalitis (HSE). Plan: The patient was switched from oral acyclovir to oral valacyclovir 2 gram TID. ARN affects both immunocompromised and immunocompetent people regardless of gender or age. The availability of HSV-2-specific polymerase chain reaction tests for diagnostic analysis has greatly increased our ability to discriminate ARN caused by HSV-2 from ARN caused by either herpes simplex virus type 1 or varicella zoster virus (VZV). Akira Urayama first described acute retinal necrosis syndrome (ARN) in 1971 as consisting of acute unilateral panuveitis associated with retinal periarteritis and progressing to diffuse necrotizing retinitis and retinal detachment. A review of 28 patients (30 eyes) with ARN suggested that patients with ARN resulting from HSV-1 or VZV are usually older (median age 47 and 57 years, respectively) whereas those patients with ARN resulting from HSV-2 are often younger (median age, 20 years). Arch Ophthalmol. Acyclovir IV 500 mg/mHerpesviruses cause ARN. Intravitreal foscarnet for the treatment of acyclovir-resistant acute retinal necrosis caused by varicella zoster virus. 2013; Schneider et al. ARN is occasionally observed in patients coincident with or following encephalitis or meningitis; in the former, ARN is usually due to HSV-1 while in the latter, ARN is usually caused by HSV-2.ARN first was described in 1971 and is a rapidly progressive necrotizing retinitis due to herpesviruses that mainly affects immunocompetent patients.Because ARN can often begin as an anterior uveitis, examination of the peripheral retina is important in all patients with a new onset of anterior inflammation. Lau C, Missotten T, et al. Incidence is usually in nonimmunocompromised adults aged 20–60 years. Ophthalmology 2010, 117: 818–824.Vemulakonda G, Pepose J, Van Gelder R. “Acute Retinal Necrosis Syndrome.” Retina, Fifth Edition, London: Elsevier, 2013, 1523-1531.Wong RW, Jumper JM, McDonald HR, et al. Virus may be detectable only during the acute phase of the disease.Amplification of the herpetic viral genome DNA by PCR in aqueous and vitreous humor was compared with Goldmann–Witmer coefficients against herpetic antigens in five patients with ARN and in two patients with CMV retinitis, using vitreous samples to determine the specificity of these diagnostic methods. The differential diagnosis of ARN is listed in ARN is a syndrome characterized by occlusive retinal vasculitis, retinal necrosis, and vitritis.No evidence of retinal vascular abnormalities may be present either clinically or angiographically early in the course of ARN. Acute Retinal Necrosis (ARN) is a debilitating eye condition involving the retina, which can cause blindness, if left untreated.The risk factors for the development of Acute Retinal Necrosis include:It is important to note that having a risk factor does not mean that one will get the condition. A study to assess the incidence of ARN in the UK revealed an incidence of approximately 1 case per 1.6–2.0 million people per year (There appears to be a difference in age distribution between ARN caused by HSV-1 or VZV and ARN caused by HSV-2, but this distribution is not absolute. credit-by-exam regardless of age or education level.Not sure what college you want to attend yet? Discussion. The inflammation onset is due to certain herpes viruses, Varicella Zoster Virus (VZV), Herpes Simplex Virus (HSV-1 and HSV-2) and Epstein-Barr Virus (EBV). Acute retinal necrosis (ARN) is a rare infectious viral uveitis syndrome that manifests as a necrotizing retinitis and may result in a devastating visual outcome if not accurately diagnosed and treated.1 The first report of this clinical entity was in 1971, but it was not until 1982 that Culbertson et al.