Choroidal Involvement in a Case of Acute Retinal Necrosis

Abstract

Purpose: To report choroidal involvement in a case of ARN.

Case report: A 26-year-old immunocompetent female presented with a history of decreased vision in the right eye for 4 days. The best corrected visual acuity in the right eye was 3/60. Anterior segment examination showed circumciliary congestion, endothelial pigments, and 1+ cells in the anterior chamber. Fundus examination revealed mild vitritis, disc edema, multifocal patchy retinitis lesions involving the fovea and mid periphery, and arteriolitis. OCT revealed an RPE bump at the macula corroborating with hypocyanacent lesions on indocyanine angiography, which persisted till the late phase, indicating choroidal involvement. The patient was started on oral valacyclovir and oral steroids. Additionally, intravitreal ganciclovir injection was added, leading to a favorable outcome. The final visual acuity post silicone oil removal was 6/60.

Conclusion: This is a unique case of ARN having choroidal involvement along with the previously described classical features.

Keywords: ARN; Acute retinal necrosis; OCT; choroiditis in ARN; rpe bump.