Epstein-Barr virus and acute retinal necrosis in a 5-year-old immunocompetent child

Roberto Gallego-Pinazo^1,2, Miguel Harto¹, Jose J Garcia-Medina^2,3, Inmaculada Serra¹, Enrique España¹, Maria D Pinazo-Duran^2,4

¹Ophthalmology Department, University Hospital, La Fe, Valencia, Spain; ²Ophthalmology Research Unit “Santiago Grisolia”, Valencia, Spain; ³Ophthalmology Department, Hospital La inmaculada, Huercal-Overa, Spain; ⁴Ophthalmology Department, Hospital Punta de Europa, Algeciras, Spain

Objective: To describe a case of bilateral acute retinal necrosis syndrome (ARNS) in a 5-year-old boy.

Method: A retrospective, interventional case is described in one child attending the pediatric ophthalmology section, complaining of sudden bilateral red eye and haze-impaired vision. A standardized ophthalmologic examination and specific serological probes supported the diagnosis of severe bilateral ARNS in an immunocompetent child.

Results: The reduced visual acuity (<20/400), the ocular fundus signs (perivasculitis, thrombosis and retinal edema) and the positive immunoglobulin M anti-Epstein Barr virus serology, lead us to the ARNS definitive diagnosis. Antiviral therapy (Acyclovir; Zovirax^®), ciclopentolate dilating eye drops, and antiplatelet treatment (acetil salicylic acid; Aspirin^®) were administered until recovering the final visual acuity (20/40).

Conclusions: The ARNS is an ocular disease with poor prognosis, which in turns may display better course when determining the etiopathogenic virus and selecting the appropriate and precocious therapy.

Keywords: retinal necrosis, Epstein-Barr virus, antiviral serology, antiviral therapy