Acute retinal necrosis syndrome after extreme diet 15 years after first manifestation
C. Woldt *, V. Seiberth *, K. F. Manthey **
Background: Acute retinal necrosis syndrome (ARN) is a rare disease which may be vision threatening by severe vasculitis with occlusion of retinal and choroidal vessels, necrotizing retinitis, vitreous infiltration and rhegmatogenous retinal detachment. ARN is caused by varizella zoster virus or herpes simplex virus. In every third patient both eyes are affected. Many years after first manifestation ARN may cause reinflammation.
Fallbericht: In a 75year-old female patient one eye had been enucleated after amaurosis caused by retinal detachment due to ARN had occured. In this globe tvaricella zoster virus DNA was detected for the first time (Rummelt V, Arch Ophthalmol 1992;110:1132-1136). After extreme fatfree and protein reduced diet becuause of elevated blood fat and blood cholesterol ARN showed reinflammation in the remaining eye. Retinal inflammation was stopped by high dosage of aciclovir and cortison. No retinal detachment occured. Final visual acuity was cc 0.5.
Conclusion: Extreme diet with protein defficiency may cause reinflammation of ARN several years after first manifestation. Physicians should be aware of this.
* Klinik für Augenheilkunde, Marienhospital, Johannisfreiheit 2-4, D-49074 Osnabrück
** Holstenstr. 59, D-24582 Bordesholm