Acute Retinal Necrosis (ARN) Due to Varicella Zoster Virus (VZV)
A patient presented with 1 week of decreased vision in the left eye. She has a history of RA, shingles, and recently began immunologic therapy with abatacept, a T-cell modulator. Examination revealed panuveitis, with an peripheral necrotizing retinitis with zone 1 involvement, and retinal vascular sheathing. The patient was diagnosed with acute retinal necrosis, and aqueous humor polymerase chain reaction later revealed varicella zoster virus positivity. The patient achieved regression of the retinal lesions on high dose Valtrex and a series of foscarnet/ganciclovir intravitreal injections. Five months after her presentation she experienced a retinal detachment and underwent pars plana vitrectomy and silicone oil injection.
Presentation Date: 02/05/2026
Issue Date: 03/27/2026
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