Acute Retinal Necrosis in an Immunocompetent Patient Treated With Intravitreal Ganciclovir

Acute retinal necrosis (ARN) is an inflammatory syndrome of high clinical concern; untreated or misdiagnosed cases may progress to optic neuropathy or retinal detachment, leading to irreversible blindness. ARN affects men and women equally and is often seen in immunocompromised patients but is also known to present in immunocompetent patients. It is usually due to systemic viral infection with secondary vitreoretinal inflammation. Most commonly, the first-line management of ARN is oral or intravenous antiviral therapy. Here, we report the case of an immunocompetent patient presenting with necrotizing retinopathy secondary to ARN. This patient was treated with oral valacyclovir and then intravenous acyclovir with no improvement. However, intravitreal injection of ganciclovir successfully halted the progression of ARN and led to the preservation of vision in the patient.