Treatment of a Patient With Acute Herpes-Associated Retinal Necrosis: A Case Report

Background. According to scientific literature, acute retinal necrosis refers to a severe uveal syndrome of viral etiology, which is characterized by the development of an inflammatory reaction in the vitreous body and anterior chamber, the appearance of rapidly progressing peripheral necrotic retinitis, occlusive vasculitis and is complicated by the development of retinal detachment in 65-75%, which can lead to complete loss of vision. The prognosis for acute retinal necrosis is relatively unfavorable; if diagnosis is not made in a timely manner and treatment is inadequate, irreversible blindness occurs; in 60% of cases, a decrease in visual function below 0.1 is observed. Clinical Case Description. Patient M., 57 years old, presented in 2023 with complaints of decreased vision, photophobia in the right eye 2 months after an acute respiratory viral infection. OD examination data: BCVA - 0.2, IOP - 29 mm Hg, anterior-posterior dimension - 23.06 mm, according to biomicroscopy data - pericorneal conjunctival injection, white precipitates of various sizes throughout the corneal endothelium. After conservative and surgical ophthalmological treatment, as well as after treatment prescribed by an infectious disease specialist, the patient has had BCVA OD - 0.1-0.2, IOP - 15-16 mm Hg, anterior-posterior dimension in 2025 - 21.63 mm. The visual field changed slightly without obvious negative dynamics. Ophthalmoscopically and according to OCT data, cystic intraretinal edema, tangential traction syndrome, preretinal membrane in the right eye without negative dynamics persist; the retina is adjacent in all meridians. Conclusion. This case highlights the importance of a comprehensive approach to the diagnosis and treatment of ophthalmological diseases caused by viral infections, as well as the need for a multidisciplinary approach in the treatment of such diseases.