Bilateral Acute Retinal Necrosis After HSV Encephalitis Post Craniotomy for Planum Meningioma

Acute retinal necrosis (ARN) is a rapidly progressive condition causing vitritis, occlusive vasculitis, and progressive peripheral necrotizing retinitis. Infectious agents include herpes simplex virus (HSV), herpes zoster virus (VZV), and cytomegalovirus (CMV). The pathway through which the virus gains access to the retina has not been completely elucidated. We present a case of bilateral ARN after HSV encephalomeningitis which occurred shortly after routine craniotomy for a planum meningioma resection suggesting a mode of transmission from the central nervous system via blood flow or directly through the optic nerves into the retina.