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This case report examines an atypical presentation of acute retinal necrosis starting in the fovea.

July 27, 2026CureusOpen Access

Foveal-Onset Acute Retinal Necrosis Associated With Varicella-Zoster Virus and Delayed Peripheral Retinitis: A Case Report

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Case report describes foveal-onset acute retinal necrosis, linked to varicella-zoster virus, improving with antiviral therapy.

This case report examines an atypical presentation of acute retinal necrosis starting in the fovea.
Described the clinical presentation of a 63-year-old man with visual impairment and ocular hypertension.
Utilized optical coherence tomography to assess retinal changes and performed multiplex PCR for diagnosis.
Administered oral valacyclovir and corticosteroids to treat the diagnosed infection.
OCT revealed a foveal lesion with marked hyperreflectivity and no detectable perfusion abnormalities.
Multiplex PCR from aqueous humor confirmed varicella-zoster virus DNA as the causative agent.
Visual acuity improved to 0.6 after treatment, with no recurrence or retinal detachment over 42 weeks.

Tsuchikawa et al. (2026) studied this question.

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