Bilateral Optic Disc Edema as an Initial Presentation of Acute Retinal Necrosis

Purpose We reported a case of acute retinal necrosis (ARN) that presented as isolated bilateral optic disc edema. Methods A case report. Case A 68-year-old male with a 3-day history of progressive blurred vision presented with isolated bilateral optic disc edema. Through history taking, we found that he was diagnosed with herpes zoster affecting the lumbar and sacral dermatomes in the past month. Five days later, the patient experienced acute deterioration in visual acuity, with the left eye deteriorating to perception of light only. Bilateral retinal necrosis was noticed. We tested the aqueous samples with polymerase chain reaction and identified positive varicella-zoster virus (VZV) results. A diagnosis of bilateral acute retinal necrosis caused by VZV infection was established and we administered intravitreal and intravenous antiviral medications, steroids, and performed prophylactic scleral buckling. This report demonstrates a rare ARN case initially presented with isolated bilateral optic disc edema.