Real-time polymerase chain reaction in acute retinal necrosis following encephalitis

• Main Authors: Vinita Rao, Jyotirmay Biswas, Gopal Lingam
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Acute retinal necrosis; herpes simplex encephalitis; herpes simplex virus; real-time polymerase chain reaction
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2018;volume=66;issue=2;spage=322;epage=324;aulast=Rao

Acute retinal necrosis (ARN) following herpes simplex encephalitis (HSE) in an immunocompetent patient is a rare condition. Quantitative real-time polymerase chain reaction (qPCR) has made it possible to identify and quantify viral genome. We report a case of ARN following HSE managed with the help of qPCR. A 45-year-old man developed ARN following HSE and was treated with intravenous acyclovir and intravitreal foscarnet. The retinitis did not respond initially and the qPCR demonstrated a rise in the number of copies of the HSV-1 viral genome. With continued treatment with intravenous acyclovir and intravitreal ganciclovir, the retinitis healed and the qPCR confirmed a reduction in the viral load. qPCR has a high sensitivity and specificity for HSV and is a useful tool for diagnosis and treatment of viral retinitis.