0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Vintage Progressive Outer Retinal Necrosis—Reply

Curtis E. Margo, MD, MPH1,2; Scott M. Friedman, MD3
[+] Author Affiliations
1Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa
2Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa
3Florida Retina Consultants, Lakeland
JAMA Ophthalmol. 2015;133(2):231. doi:10.1001/jamaophthalmol.2014.4512.
Text Size: A A A
Published online

Extract

In Reply Spaide questions why we selected the case report of PORN by Greven et al1 as a key reference when the association with varicella-zoster virus infection was established by polymerase chain reaction and not by light or electron microscopic localization of viral inclusions or capsids. First, we believe the ophthalmoscopic findings and clinical course of the disorder were consistent with the clinical condition referred to as PORN. Second, the polymerase chain reaction procedure described by Greven and colleagues included safeguards that minimized false-positive results. Third, their Figure 4A demonstrates at least 2 retinal cells that contain intranuclear inclusions, consistent with viral retinitis. The particular reason we cited this study, though, is because it included a histopathologic photograph of partial retinal necrosis. Besides our case, we are not aware of another example that depicts early involvement in PORN. In their Figure 4B, Greven and colleagues show partial retinal necrosis with relative preservation of the outer retina. Although the authors do not mention the incongruity of this finding with the acronym, their illustration raises the same remarkable question that Lorenz E. Zimmerman, MD, asked: if necrosis of the inner retina precedes that of the outer retina, why does deep retina appear involved first on ophthalmoscopic examination?

Topics

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

February 1, 2015
Richard F. Spaide, MD
1Vitreous Retina Macula Consultants of New York, New York
JAMA Ophthalmol. 2015;133(2):230-231. doi:10.1001/jamaophthalmol.2014.4486.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

220 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();