Acute Retinal Necrosis Associated with Epstein-Barr Virus in a Patient Undergoing Immunosuppressive Therapy.
Acute Retinal Necrosis Associated with Epstein-Barr Virus in a Patient Undergoing Immunosuppressive Therapy.
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DOI：
10.1159/000445372
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发表时间：
2016-01
影响因子：
0.4
通讯作者：
Ohguro H
中科院分区：
文献类型：
--
作者：
Oe C;Hiraoka M;Tanaka S;Ohguro H
急性视网膜坏死（ARN）是一种快速进展和严重的视网膜炎，导致视力不良的结果。由疱疹病毒如单纯疱疹病毒（HSV）1型和2型或水痘带状疱疹病毒（VZV）引起的感染已知与ARN的发展有关。在本研究中，一个80岁的女性与ARN进行了检查。她患有类风湿性关节炎，服用甲氨蝶呤超过10年。她的右眼表现出ARN的临床特征，左眼表现出轻度视网膜炎。通过全面的聚合酶链反应（PCR）测定分析她右眼的房水和玻璃体液中的基因组DNA，以筛选包括病毒在内的感染性病原体。两份标本均检出EB病毒（EBV），但均未检出HSV或VZV或巨细胞病毒。她接受眼内手术后，全身皮质类固醇和阿昔洛韦的应用。然而，虽然她右眼的视网膜炎被扑灭，但最终的视力结果是由于视神经萎缩而失明。有少数报告表明，EBV与ARN的发展。目前的研究结果表明，单独的EB病毒可能是ARN的病原体。
Acute retinal necrosis (ARN) is a rapidly progressive and severe retinitis resulting in a poor visual outcome. Infections caused by herpes viruses such as herpes simplex virus (HSV) types 1 and 2 or the varicella zoster virus (VZV) are known to be implicated in the development of ARN. In the present study, an 80-year-old female with ARN was examined. She had been affected with rheumatoid arthritis and had taken methotrexate for over 10 years. Her right eye showed clinical features of ARN, and her left eye showed mild retinitis. The genomic DNA in the aqueous humor and vitreous fluid from her right eye were analyzed by a comprehensive polymerase chain reaction (PCR) assay to screen infectious pathogens including viruses. The Epstein-Barr virus (EBV) was detected from both specimens, but neither HSV or VZV nor cytomegalovirus was detected. She underwent intraocular surgery following systemic corticosteroid and acyclovir applications. However, although the retinitis of her right eye was extinguished, the final visual outcome was blindness due to optic nerve atrophy. There are few reports indicating that EBV is associated with ARN development. The present findings suggest that EBV alone can be the causative agent of ARN.