Atypical Herpetic Viral Posterior Uveitis: Non-necrotising Retinitis and Focal Retinitis

Abstract

Human herpes viruses are the most common etiologic agents in posterior viral uveitis. They remain latent in the infected host with a risk of reactivation that depends on various factors, including virulence, host immunity, age and comorbidities. Acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN), and CMV retinitis are the most frequent forms. Posterior viral uveitis may occur in atypical clinical entities as non-necrotising herpetic retinitis (NNHR) and focal posterior viral retinitis. The spectrum of herpetic retinopathies might start with focal retinitis, the mildest form, and followed by more severe forms as NNHR, PORN and ARN. The differential diagnosis of atypical viral retinitis is difficult clinically, as it can mimic various kinds of retinitis. The prognosis of the atypical disease is better than other forms of necrotizing retinopathies. A viral etiology must be considered in cases of sightthreatening and atypical posterior uveitis that is unresponsive to conventional corticosteroid treatment.