Progressive outer retinal necrosis complicated by combined central retinal vein and central retinal artery occlusions.

PURPOSE: To describe an uncommon presentation and course of progressive outer retinal necrosis. METHODS: A 36-year-old man presented with unilateral optic disk edema with enhancement of the optic nerve sheath shown by magnetic resonance imaging. Intravenous methylprednisolone treatment was initiated. RESULTS: Two days later, he developed multiple discrete areas of outer retinal opacification with areas of confluence in the periphery of the retina. Results of laboratory testing for antibody to human immunodeficiency virus were positive. Therapy for progressive outer retinal necrosis was initiated, and the patient developed combined central retinal vein and central retinal artery occlusions 3 days later. CONCLUSIONS: Although usually characterized by a lack of vascular inflammation, progressive outer retinal necrosis may lead to vascular occlusions.