Japanese Journal of Ophthalmology

, Volume 63, Issue 4, pp 304–309 | Cite as

Acute retinal necrosis following herpes simplex encephalitis: a nationwide survey in Japan

  • Daisuke TodokoroEmail author
  • Satoshi Kamei
  • Hiroshi Goto
  • Yoshio Ikeda
  • Hiroshi Koyama
  • Hideo Akiyama
Clinical Investigation



Acute retinal necrosis (ARN) is a severe necrotizing retinitis caused by varicella-zoster virus or herpes simplex virus (HSV) that often results in blindness. Occasionally, HSV-caused ARN develops after herpes simplex encephalitis (HSE). It remains unknown, however, when and how often ARN develops after HSE. To investigate the actual conditions of patients with ARN following HSE and the interval period between the prior HSE and the onset of ARN, a retrospective nationwide survey of the Japanese population was performed.

Study design



Questionnaires were sent out to the neurology and ophthalmology departments of teaching hospitals in Japan. They inquired about HSE patients in neurology departments and ARN patients diagnosed with HSV in ophthalmology departments. The proportion of the HSV-ARN patients with a history of HSE and their interval periods were obtained from the questionnaires returned by the ophthalmology departments.


Neurology departments of 324 hospitals responded to the questionnaires (response proportion: 40.9%), and 53 HSE cases were reported. Ophthalmology departments of 535 hospitals responded the questionnaires (response proportion: 54.3%), and 67 HSV-ARN cases were reported. Among the 67 HSV-ARN cases, 16 (23.9%) had histories of prior HSE. Although the interval periods from the prior HSE to the onset of HSV-ARN varied among cases, nearly half developed HSV-ARN within 2 years.


This nationwide survey of the Japanese population showed that HSV-ARN develops after HSE in higher frequency within 2 years. Neurologists and ophthalmologists should be aware that HSE survivors have a risk of contracting HSV-ARN.


Acute retinal necrosis Herpes simplex encephalitis Herpes simplex virus 



We would like to thank all of the doctors who responded to our questionnaires, and Ms. Masumi Ishikawa for her assistance with this survey.

Conflicts of interest

D.Todokoro, None; S.Kamei, None; H.Goto, None; Y.Ikeda, None; H.Koyama, None; H.Akiyama, None.


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Copyright information

© Japanese Ophthalmological Society 2019

Authors and Affiliations

  • Daisuke Todokoro
    • 1
    Email author
  • Satoshi Kamei
    • 2
  • Hiroshi Goto
    • 3
  • Yoshio Ikeda
    • 4
  • Hiroshi Koyama
    • 5
  • Hideo Akiyama
    • 1
  1. 1.Department of OphthalmologyGunma University Graduate School of MedicineMaebashiJapan
  2. 2.Division of Neurology, Department of MedicineNihon University School of MedicineItabashiJapan
  3. 3.Department of OphthalmologyTokyo Medical UniversityShinjukuJapan
  4. 4.Department of NeurologyGunma University Graduate School of MedicineMaebashiJapan
  5. 5.Department of Public HealthGunma University Graduate School of MedicineMaebashiJapan

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