H1N1-associated acute retinitis

Purpose: To present the first reported case of bilateral H ₁N₁-associated acute retinitis and its successful treatment. Design: Interventional case report. Methods: A 41-year-old HIV-positive male presented with acute vision loss, panuveitis, and retinitis. A diagnostic and therapeutic vitrectomy with intravitreal injection of vancomycin and ganciclovir and endolaser was performed. One month later, the patient returned with similar symptoms in the fellow eye and underwent the same procedure. Results: ELISA immunoassay revealed H₁N₁ antibodies in both the vitreous and serum. PCR for herpes viruses included HSV, CMV, and VZV. Bacterial and fungal cultures were negative. On 1-year follow-up, the vision remained 20/20 in both eyes without evidence of recurrent inflammation. Conclusions: H₁N₁ should be included in the differential diagnosis of any patient with a history of recent influenza A (H₁N₁) infection and acute retinitis. H₁N ₁ may carry a better prognosis than other viruses causing acute retinitis.