Epstein-Barr virus and acute retinal necrosis in a 5-year-old immunocompetent child

Abstract

Objective: To describe a case of bilateral acute retinal necrosis syndrome (ARNS) in a 5-year-old boy. Method: A retrospective, interventional case is described in one child attending the pediatric ophthalmology section, complaining of sudden bilateral red eye and haze-impaired vision. A standardized ophthalmologic examination and specific serological probes supported the diagnosis of severe bilateral ARNS in an immunocompetent child. Results: The reduced visual acuity (<20/400), the ocular fundus signs (perivasculitis, thrombosis and retinal edema) and the positive immunoglobulin M anti-Epstein Barr virus serology, lead us to the ARNS definitive diagnosis. Antiviral therapy (Acyclovir; Zovirax), ciclopentolate dilating eye drops, and antiplatelet treatment (acetil salicylic acid; Aspirin) were administered until recovering the final visual acuity (20/40). Conclusions: The ARNS is an ocular disease with poor prognosis, which in turns may display better course when determining the etiopathogenic virus and selecting the appropriate and precocious therapy.