ABSTRACT
PURPOSE: To describe a case of progressive outer retinal necrosis syndrome, successfully treated with a new combination of antiviral drugs. METHODS: The patient was treated with a combined therapy of antiviral drugs that includes: intravenous acyclovir 10 mg/kg, three intravitreal injections of foscarnet (1200 microg) and a ganciclovir implant in the right eye. RESULTS: The progressive outer retinal necrosis appeared to response dramatically with the combination of antiviral agents used over a period of 2 weeks with a final visual acuity of 20/80 at 3 months of follow up. CONCLUSIONS: Intravitreal foscarnet combined with i.v. acyclovir and ganciclovir implant may represent an effective alternative treatment for PORN.
Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Antiviral Agents/therapeutic use , Eye Infections, Viral/drug therapy , Herpes Simplex/drug therapy , Retinal Necrosis Syndrome, Acute/drug therapy , AIDS-Related Opportunistic Infections/pathology , AIDS-Related Opportunistic Infections/virology , Acyclovir/administration & dosage , Adult , Disease Progression , Drug Implants , Drug Therapy, Combination , Eye Infections, Viral/pathology , Eye Infections, Viral/virology , Foscarnet/administration & dosage , Ganciclovir/administration & dosage , Herpes Simplex/pathology , Herpes Simplex/virology , Humans , Male , Retinal Necrosis Syndrome, Acute/pathology , Retinal Necrosis Syndrome, Acute/virologyABSTRACT
PURPOSE: Macular translocation has been proposed as an alternative technique in the treatment of some cases of choroidal neovascularization. The purpose of the paper is to report the histopathologic findings in the retina of swine eyes undergone macular translocation. METHODS: Ten eyes of ten Yucatan pigs underwent posterior pars plana vitrectomy and scleral imbrication to achieve macular translocation. Mattress sutures were preplaced at the equator of the eyes. After a pars plana vitrectomy, balanced saline solution was injected under the temporal retina to produce a retinal detachment. Scleral imbrication was achieved by tightening the mattress sutures. An air-fluid exchange was performed and the eye was filled with sulfur hexafluoride 18%. The eyes were enucleated 2, 4, 8 and 12 weeks after surgery and analyzed under light and electron microscopy. RESULTS: Macular translocation was achieved in all cases. The major findings consist of a minimal decrease in the number of photoreceptors outer segments; also a change in the morphology was noted. This included some degree of loss of vertical alignment and an increase in the interphotoreceptor space. There was a recovery in the morphology of the photoreceptors over time. CONCLUSIONS: Minimal changes in the photoreceptors and retinal pigment epithelium are observed when macular translocation is performed with recovery of these changes over time. Scleral imbrication is an effective technique to achieve translocation of the fovea.
