Acute retinal necrosis with exudative retinal detachment in a child

2021 ◽  
Vol 14 (12) ◽  
pp. e245984
Author(s):  
Benish Aslam Perhiar ◽  
MA Rehman Siddiqui ◽  
Shahnaz Ibrahim

Acute retinal necrosis (ARN) is a rare ocular emergency caused mainly by viral entities. ARN may be caused by Herpes zoster virus (HZV) and Herpes simplex virus (HSV), both HSV-1 and HSV-2. ARN mostly present in 20–60 years old immunocompetent adults. A 7-year-old girl presented to the eye clinic with complaints of left eye redness noted by her mother for 2–3 days. On examination with indirect ophthalmoscopy, no hypopyon was seen in either eye. In the left eye fundus view was hazy. Ultrasound B-scan performed showed exudative retinal detachment. PCR of ocular fluid was positive for HSV-1 DNA. The patient was started on topical steroids and antibiotics and systemic antivirals. In addition, she also received intravitreal ganciclovir 4 mg/0.1 mL three times under general anaesthesia. At her last follow-up, 3 years from her presentation, her right eye examination was within normal limits, and left eye showed thick vitreous bands with a posterior vitreous detachment, and left inferotemporal retinal scarring.

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1856
Author(s):  
Emily Greenan ◽  
Sophie Gallagher ◽  
Rana Khalil ◽  
Conor C. Murphy ◽  
Joan Ní Gabhann-Dromgoole

Herpes stromal keratitis (HSK) is a disease that commonly affects the cornea and external eye and is caused by Herpes Simplex Virus type 1 (HSV-1). This virus infects approximately 66% of people worldwide; however, only a small portion of these people will develop symptoms in their lifetime. There is no cure or vaccine available for HSV-1; however, there are treatments available that aim to control the inflammation caused by the virus and prevent its recurrence. While these treatments are beneficial to those suffering with HSK, there is a need for more effective treatments to minimise the need for topical steroids, which can have harmful effects, and to prevent bouts of disease reactivation, which can lead to progressive corneal scarring and visual impairment. This review details the current understanding of HSV-1 infection and discusses potential novel treatment options including microRNAs, TLRs, mAbs, and aptamers.


2019 ◽  
Vol 12 (5) ◽  
pp. e229137 ◽  
Author(s):  
Takaaki Kobayashi ◽  
Poorani Sekar ◽  
Jeffery Meier ◽  
Judy Streit

A 60-year-old man with a history of severe herpes simplex virus type 1 (HSV-1) encephalitis 2 years prior presented with acute onset of visual loss in the left eye. Dilated funduscopic examination showed retinitis and occlusive vasculitis with retinal necrosis. PCR of the vitreous fluid was positive for HSV-1, and he was diagnosed with acute retinal necrosis (ARN) due to HSV-1. The patient was treated with intravenous acyclovir and intravitreous foscarnet for 2 weeks, followed by high dose oral valacyclovir for 2 weeks. He was subsequently placed on planned life-long suppressive valacyclovir. His case demonstrates that acute visual loss concomitant with or subsequent to HSV-1 encephalitis warrants suspicion of ARN. Prompt therapy with effective antiviral medication is necessary to reduce the risk of sight-threatening complications. Chronic suppression with oral antiviral therapy after ARN is recommended to prevent involvement of the contralateral eye, though there is no consensus on the duration and dosage of antivirals.


2019 ◽  
Vol 48 (8) ◽  
pp. 030006051984737
Author(s):  
Boding Tong ◽  
Chao Wang ◽  
Xin Qi

Nanophthalmos is a developmental ocular malformation that has been associated with high risks of uveal effusion syndrome and exudative retinal detachment (ERD). A variety of surgical procedures and systemic/topical steroids have been described as effective for treatment of ERD. However, the possibility of side effects should be considered. Here, we describe a patient with nanophthalmos who was treated for recurrent ERD during long-term follow-up, and we discuss non-surgical treatment options that are available in such cases. A 43-year-old woman with bilateral nanophthalmos exhibited ERD in her right eye for one month. After partial thickness sclerectomy with central sclerostomy, the retina was completely reattached. However, ERD recurred 3 years later. The patient refused surgery; therefore, we employed conservative treatment of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and observation. One month later, the retina was completely reattached. To the best of our knowledge, no previous report has described resolution of recurrent ERD in a patient with nanophthalmos using NSAIDs during long-term follow-up after successful surgical treatment. Our success using this approach suggests that it could be used as alternative treatment for ERD in patients with nanophthalmos before application of further treatments.


2021 ◽  
Vol 3 (2) ◽  
pp. 27-29
Author(s):  
W. Akioud ◽  
T. Abdellaoui ◽  
A. Elkhouyali ◽  
F. Elasri ◽  
Y. Mozari ◽  
...  

Acute retinal necrosis (ARN) is an inflammatory condition characterized by a peripheral retinal necrosis due to an infection with varicella-zoster virus or herpes simplex virus. It is commonly seen in immunocompetent adults and is known for its rapid evolution and poor prognosis. Our case study illustrates the gravity of this condition with an extremely rapid ARN that was hard to diagnose.


Author(s):  
Z. Hong Zhou ◽  
Jing He ◽  
Joanita Jakana ◽  
J. D. Tatman ◽  
Frazer J. Rixon ◽  
...  

Herpes simplex virus-1 (HSV-1) is a ubiquitous virus which is implicated in diseases ranging from self-curing cold sores to life-threatening infections. The 2500 Å diameter herpes virion is composed of a glycoprotein spike containing, lipid envelope, enclosing a protein layer (the tegument) in which is embedded the capsid (which contains the dsDNA genome). The B-, and A- and C-capsids, representing different morphogenetic stages in HSV-1 infected cells, are composed of 7, and 5 structural proteins respectively. The three capsid types are organized in similar T=16 icosahedral shells with 12 pentons, 150 hexons, and 320 connecting triplexes. Our previous 3D structure study at 26 Å revealed domain features of all these structural components and suggested probable locations for the outer shell proteins, VP5, VP26, VP19c and VP23. VP5 makes up most of both pentons and hexons. VP26 appeared to bind to the VP5 subunit in hexon but not to that in penton.


2015 ◽  
Vol 89 (15) ◽  
pp. 7932-7943 ◽  
Author(s):  
Tessa M. Campbell ◽  
Brian P. McSharry ◽  
Megan Steain ◽  
Barry Slobedman ◽  
Allison Abendroth

ABSTRACTNatural killer (NK) cell-deficient patients are particularly susceptible to severe infection with herpesviruses, especially varicella-zoster virus (VZV) and herpes simplex virus 1 (HSV-1). The critical role that NK cells play in controlling these infections denotes an intricate struggle for dominance between virus and NK cell antiviral immunity; however, research in this area has remained surprisingly limited. Our study addressed this absence of knowledge and found that infection with VZV was not associated with enhanced NK cell activation, suggesting that the virus uses specific mechanisms to limit NK cell activity. Analysis of viral regulation of ligands for NKG2D, a potent activating receptor ubiquitously expressed on NK cells, revealed that VZV differentially modulates expression of the NKG2D ligands MICA, ULBP2, and ULBP3 by upregulating MICA expression while reducing ULBP2 and ULBP3 expression on the surface of infected cells. Despite being closely related to VZV, infection with HSV-1 produced a remarkably different effect on NKG2D ligand expression. A significant decrease in MICA, ULBP2, and ULBP3 was observed with HSV-1 infection at a total cellular protein level, as well as on the cell surface. We also demonstrate that HSV-1 differentially regulates expression of an additional NKG2D ligand, ULBP1, by reducing cell surface expression while total protein levels are unchanged. Our findings illustrate both a striking point of difference between two closely related alphaherpesviruses, as well as suggest a powerful capacity for VZV and HSV-1 to evade antiviral NK cell activity through novel modulation of NKG2D ligand expression.IMPORTANCEPatients with deficiencies in NK cell function experience an extreme susceptibility to infection with herpesviruses, in particular, VZV and HSV-1. Despite this striking correlation, research into understanding how these two alphaherpesviruses interact with NK cells is surprisingly limited. Through examination of viral regulation of ligands to the activating NK cell receptor NKG2D, we reveal patterns of modulation by VZV, which were unexpectedly varied in response to regulation by HSV-1 infection. Our study begins to unravel the undoubtedly complex interactions that occur between NK cells and alphaherpesvirus infection by providing novel insights into how VZV and HSV-1 manipulate NKG2D ligand expression to modulate NK cell activity, while also illuminating a distinct variation between two closely related alphaherpesviruses.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
David Shahnazaryan ◽  
Rana Khalil ◽  
Claire Wynne ◽  
Caroline A. Jefferies ◽  
Joan Ní Gabhann-Dromgoole ◽  
...  

AbstractHerpes simplex keratitis (HSK), caused by herpes simplex virus type 1 (HSV-1) infection, is the commonest cause of infectious blindness in the developed world. Following infection the virus is initially suspended in the tear film, where it encounters a multi-pronged immune response comprising enzymes, complement, immunoglobulins and crucially, a range of anti-viral and pro-inflammatory cytokines. However, given that HSV-1 can overcome innate immune responses to establish lifelong latency throughout a susceptible individual’s lifetime, there is significant interest in understanding the mechanisms employed by HSV-1 to downregulate the anti-viral type I interferon (IFN) mediated immune responses. This study aimed to investigate the interactions between infected cell protein (ICP)0 and key elements of the IFN pathway to identify possible novel targets that contribute to viral immune evasion. Reporter gene assays demonstrated the ability of ICP0 to inhibit type I IFN activity downstream of pathogen recognition receptors (PRRs) which are known to be involved in host antiviral defences. Further experiments identified interferon regulatory factor (IRF)7, a driver of type I IFN, as a potential target for ICP0. These findings increase our understanding of the pathogenesis of HSK and suggest IRF7 as a potential therapeutic target.


Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1148
Author(s):  
Fouad S. El-mayet ◽  
Kelly S. Harrison ◽  
Clinton Jones

Expression of Krüppel-like factor 15 (KLF15), a stress-induced transcription factor, is induced during bovine herpesvirus 1 (BoHV-1) reactivation from latency, and KLF15 stimulates BoHV-1 replication. Transient transfection studies revealed that KLF15 and glucocorticoid receptor (GR) cooperatively transactivate the BoHV-1-immediate-early transcription unit 1 (IEtu1), herpes simplex virus type 1 (HSV-1) infected cell protein 0 (ICP0), and ICP4 promoters. The IEtu1 promoter drives expression of bICP0 and bICP4, two key BoHV-1 transcriptional regulatory proteins. Based on these studies, we hypothesized infection is a stressful stimulus that increases KLF15 expression and enhances productive infection. New studies demonstrated that silencing KLF15 impaired HSV-1 productive infection, and KLF15 steady-state protein levels were increased at late stages of productive infection. KLF15 was primarily localized to the nucleus following infection of cultured cells with HSV-1, but not BoHV-1. When cells were transfected with a KLF15 promoter construct and then infected with HSV-1, promoter activity was significantly increased. The ICP0 gene, and to a lesser extent, bICP0 transactivated the KLF15 promoter in the absence of other viral proteins. In contrast, BoHV-1 or HSV-1 encoded VP16 had no effect on KLF15 promoter activity. Collectively, these studies revealed that HSV-1 and BoHV-1 productive infection increased KLF15 steady-state protein levels, which correlated with increased virus production.


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