Acute retinal necrosis in a monocular patient complicated by acyclovir-induced nephrotoxicity.

摘要

A 40 year-old male with history of enucleation of the right eye (OD) during childhood for a "benign tumor" developed sudden photophobia in his left eye (OS). Over the ensuing week, his condition progressed to floaters, blurry vision and injection. The patient was treated with sulfacetamide/prednisolone ophthalmic suspension, followed by fluorometholone. His condition did not improve and he presented to our eye clinic. His exam OS revealed 20/30 acuity, anterior chamber inflammation, 360? peripheral retinal necrosis with hemorrhages, and vitreous haze. A diagnosis of acute retinal necrosis (ARN) was made, intravitreal foscarnet (2.4mg) was given and intravenous (IV) acyclovir (15 mg/kg every 8 h), topical moxifloxacin, prednisolone and cyclopentolate were started. On the day of admission, his serum creatinine (SCr) was 0.6mg/dL. On the next morning, he received his second dose of IV acyclovir and his SCr was 0.9 mg/dL.