Progressive outer retinal necrosis: Difference between revisions
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{{Infobox medical condition | |||
| name = Progressive outer retinal necrosis | |||
| image = [[File:PMID20029144_05_progressive_outer_retinal_necrosis_-_cracked_mud.png|left|thumb|Progressive outer retinal necrosis]] | |||
| caption = Fundus photograph showing the characteristic "cracked mud" appearance of progressive outer retinal necrosis | |||
| field = [[Ophthalmology]] | |||
| symptoms = Rapidly progressive vision loss, [[retinal detachment]], [[vitritis]], [[retinal necrosis]] | |||
| complications = [[Blindness]], [[retinal detachment]] | |||
| onset = Rapid | |||
| duration = Variable | |||
| causes = [[Varicella zoster virus]], [[Herpes simplex virus]] | |||
| risks = [[Immunocompromised]] state, [[HIV/AIDS]], [[organ transplantation]] | |||
| diagnosis = Clinical examination, [[fundus photography]], [[PCR]] testing of ocular fluids | |||
| differential = [[Cytomegalovirus retinitis]], [[acute retinal necrosis]] | |||
| treatment = [[Antiviral drugs]], [[intravitreal injection]], [[vitrectomy]] | |||
| prognosis = Poor if untreated; variable with treatment | |||
| frequency = Rare | |||
}} | |||
'''Progressive Outer Retinal Necrosis''' (PORN) is a severe [[infection]] of the [[retina]] that can lead to [[blindness]]. It is a variant of [[necrotizing herpetic retinopathy]], and is typically seen in patients with severely compromised [[immune system]]s, such as those with [[AIDS]] or those undergoing [[immunosuppressive therapy]]. | '''Progressive Outer Retinal Necrosis''' (PORN) is a severe [[infection]] of the [[retina]] that can lead to [[blindness]]. It is a variant of [[necrotizing herpetic retinopathy]], and is typically seen in patients with severely compromised [[immune system]]s, such as those with [[AIDS]] or those undergoing [[immunosuppressive therapy]]. | ||
==Etiology== | ==Etiology== | ||
Progressive outer retinal necrosis is caused by the [[varicella-zoster virus]] (VZV), the same virus that causes [[chickenpox]] and [[shingles]]. The virus lies dormant in the [[nerve cells]] and can reactivate in individuals with weakened immune systems, leading to PORN. | Progressive outer retinal necrosis is caused by the [[varicella-zoster virus]] (VZV), the same virus that causes [[chickenpox]] and [[shingles]]. The virus lies dormant in the [[nerve cells]] and can reactivate in individuals with weakened immune systems, leading to PORN. | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
Patients with progressive outer retinal necrosis typically present with rapidly progressive, painless, bilateral [[vision loss]]. Other symptoms may include [[floaters]], [[photopsia]] (flashes of light), and [[peripheral vision]] loss. On [[ophthalmic examination]], multiple areas of retinal necrosis with clear borders can be seen in the peripheral retina, along with [[vasculitis]] and [[optic nerve]] pallor. | Patients with progressive outer retinal necrosis typically present with rapidly progressive, painless, bilateral [[vision loss]]. Other symptoms may include [[floaters]], [[photopsia]] (flashes of light), and [[peripheral vision]] loss. On [[ophthalmic examination]], multiple areas of retinal necrosis with clear borders can be seen in the peripheral retina, along with [[vasculitis]] and [[optic nerve]] pallor. | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of PORN is primarily clinical, based on the characteristic appearance of the retina on examination. [[Fluorescein angiography]] and [[optical coherence tomography]] may be used to confirm the diagnosis. [[Polymerase chain reaction]] (PCR) testing of [[aqueous humor]] or [[vitreous humor]] can be used to detect VZV DNA and confirm the etiology. | Diagnosis of PORN is primarily clinical, based on the characteristic appearance of the retina on examination. [[Fluorescein angiography]] and [[optical coherence tomography]] may be used to confirm the diagnosis. [[Polymerase chain reaction]] (PCR) testing of [[aqueous humor]] or [[vitreous humor]] can be used to detect VZV DNA and confirm the etiology. | ||
==Treatment== | ==Treatment== | ||
Treatment of progressive outer retinal necrosis involves aggressive systemic [[antiviral therapy]] to control the VZV infection, along with [[corticosteroids]] to reduce inflammation. Despite treatment, the prognosis is often poor, with many patients experiencing severe vision loss or blindness. | Treatment of progressive outer retinal necrosis involves aggressive systemic [[antiviral therapy]] to control the VZV infection, along with [[corticosteroids]] to reduce inflammation. Despite treatment, the prognosis is often poor, with many patients experiencing severe vision loss or blindness. | ||
==See Also== | ==See Also== | ||
* [[Retinitis]] | * [[Retinitis]] | ||
| Line 22: | Line 31: | ||
* [[Acute retinal necrosis]] | * [[Acute retinal necrosis]] | ||
* [[Varicella-zoster virus]] | * [[Varicella-zoster virus]] | ||
[[Category:Ophthalmology]] | [[Category:Ophthalmology]] | ||
[[Category:Infectious diseases]] | [[Category:Infectious diseases]] | ||
[[Category:Viral diseases]] | [[Category:Viral diseases]] | ||
[[Category:Retinal disorders]] | [[Category:Retinal disorders]] | ||
{{Virus-stub}} | {{Virus-stub}} | ||
Latest revision as of 22:08, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
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| Progressive outer retinal necrosis | |
|---|---|
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Rapidly progressive vision loss, retinal detachment, vitritis, retinal necrosis |
| Complications | Blindness, retinal detachment |
| Onset | Rapid |
| Duration | Variable |
| Types | N/A |
| Causes | Varicella zoster virus, Herpes simplex virus |
| Risks | Immunocompromised state, HIV/AIDS, organ transplantation |
| Diagnosis | Clinical examination, fundus photography, PCR testing of ocular fluids |
| Differential diagnosis | Cytomegalovirus retinitis, acute retinal necrosis |
| Prevention | N/A |
| Treatment | Antiviral drugs, intravitreal injection, vitrectomy |
| Medication | N/A |
| Prognosis | Poor if untreated; variable with treatment |
| Frequency | Rare |
| Deaths | N/A |
Progressive Outer Retinal Necrosis (PORN) is a severe infection of the retina that can lead to blindness. It is a variant of necrotizing herpetic retinopathy, and is typically seen in patients with severely compromised immune systems, such as those with AIDS or those undergoing immunosuppressive therapy.
Etiology[edit]
Progressive outer retinal necrosis is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox and shingles. The virus lies dormant in the nerve cells and can reactivate in individuals with weakened immune systems, leading to PORN.
Clinical Presentation[edit]
Patients with progressive outer retinal necrosis typically present with rapidly progressive, painless, bilateral vision loss. Other symptoms may include floaters, photopsia (flashes of light), and peripheral vision loss. On ophthalmic examination, multiple areas of retinal necrosis with clear borders can be seen in the peripheral retina, along with vasculitis and optic nerve pallor.
Diagnosis[edit]
Diagnosis of PORN is primarily clinical, based on the characteristic appearance of the retina on examination. Fluorescein angiography and optical coherence tomography may be used to confirm the diagnosis. Polymerase chain reaction (PCR) testing of aqueous humor or vitreous humor can be used to detect VZV DNA and confirm the etiology.
Treatment[edit]
Treatment of progressive outer retinal necrosis involves aggressive systemic antiviral therapy to control the VZV infection, along with corticosteroids to reduce inflammation. Despite treatment, the prognosis is often poor, with many patients experiencing severe vision loss or blindness.
See Also[edit]
