Two Cases of Acute Retinal Necrosis Treated With Systemic Antiviral Drugs and Intravitreal Antiviral Injections

ABSTRACT

PURPOSE:To report the use of intravitreal antiviral injections as adjunctive therapy in the managementof two immunocompetent patients with acute retinal necrosis. CASE SUMMARY: We performed two or three intravitreal injections of gancyclovir (2,000 microg/0.05 ml) on two patients (two eyes) with acute retinal necrosis resistant to intravenous acyclovir therapy (1,500 mg/m2/day). Both patients received intravitreal antiviral injections for the treatment of retinitis that progressed despite standard intravenous acyclovir therapy. The retinitis resolved, and visual acuity improved after 18 months of follow-up in both cases. CONCLUSIONS: Intravitreal antiviral injections may be a safe and efficacious adjunctive therapy in the management of patients with acute retinal necrosis resistant to intravenous acyclovir therapy.