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Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Central Retinal Vascular Occlusion Associated With Acute Retinal Necrosis Arch Ophthalmol. 2012;130(4):514-517. doi:10.1001/archophthalmol.2011.1735 Figure 1. Fundus photographs of the left eye of a 66-year-old man (case 1) that show hazy media secondary to vitreous hemorrhage. There was diffuse retinal pallor and a cherry-red spot, as well as diffuse retinal hemorrhages within the major vascular arcades (A) and in the midretinal and far-retinal periphery (B). No focal retinal necrosis was discernible. Fluorescein angiographic images show poor arterial perfusion (C) and impaired arterial and venous filling at 5 minutes and 39 seconds (D). There was also diffuse leakage from the optic nerve with masking defects corresponding to retinal hemorrhage. Following a diagnostic pars plana vitrectomy, widespread retinal necrosis with central retinal whitening, as well as peripheral retinal necrosis and diffuse hemorrhages, are more apparent (E). Results of quantitative polymerase chain reaction showed more than 25 × 10 6 copies/mL of varicella zoster virus DNA. Figure Legend:
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Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Central Retinal Vascular Occlusion Associated With Acute Retinal Necrosis Arch Ophthalmol. 2012;130(4):514-517. doi:10.1001/archophthalmol.2011.1735 Figure 2. A, Fundus photograph of the right eye of a 64-year-old woman (case 2) that shows 2+ vitreous haze, optic nerve pallor, and an ellipse-shaped area of retinal whitening superotemporal to the optic nerve (white arrow). Result of polymerase chain reaction was positive for herpes simplex virus type 2 DNA. Following pars plana vitrectomy, membrane peel, endolaser, and silicone oil instillation for a vitreous hemorrhage and tractional retinal detachment, a fundus photograph showed extremely sclerotic retinal arterioles and optic nerve pallor (B). Fluorescein angiographic images show a global delay in arterial perfusion with arterial filling at 21 seconds (C) and delayed venous filling, which was consistent with a central retinal artery occlusion (D). Figure Legend:
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Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Central Retinal Vascular Occlusion Associated With Acute Retinal Necrosis Arch Ophthalmol. 2012;130(4):514-517. doi:10.1001/archophthalmol.2011.1735 Figure 3. Fundus photographs of the right eye of an 87-year-old man (case 3) that show 1+ vitreous haze, optic nerve pallor, punctate intraretinal hemorrhage, and extremely sclerotic-appearing retinal arterioles (A) with areas of vascular dropout (B). In the peripheral retina anterior to the equator, there was a 2 to 3 clock-hour zone of retinitis with villiform projections (C), all of which resolved following antiviral therapy. Fluorescein angiographic images show absent perfusion at 37 seconds (D), poor arterial blood flow at 2 minutes and 30 seconds (E), and poor venous filling in the late recirculation phase (F). Figure Legend:
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