Successful treatment of progressive outer retinal necrosis syndrome

Purpose: Progressive outer retinal necrosis is a destructive retinopathy found in patients with acquired immune deficiency syndrome. Treatment of this disorder has been unsuccessful in reported patient series, with the patients experiencing profound bilateral loss of vision. Methods: We treated six patients with combination antiviral therapy, usually with intravenous foscarnet and either ganciclovir or acyclovir. Results: These six patients retained a visual acuity of 20/100 or better in at least one eye for the remainder of their lives (a period >4 months for each patient), Retinal detachments developed in four patients, for which vitrectomy and silicone oil tamponade were required. Conclusions: A combination of intravenous antiviral therapy and aggressive vitrectomy techniques to repair any associated detachments may allow the preservation of useful visual acuity in patients with progressive outer retinal necrosis. This is the first reported series of successful long-term treatment of patients with this disorder.