IN Better Health
with Adam Diaz
by Leah Draffen
Adam Diaz with his family. 38
WHEN ADAM DIAZ’S only working eye became red and light sensitive, he went to see an Ophthalmologist who referred him to a local retina specialist. He was sent home with steroid eyedrops and instructions to call back in two weeks. Yet, Adam felt his condition was more urgent. Advocating for himself, he began looking elsewhere for a retina specialist. He says, “That’s when I found Dr. Kathy Ta at the Retina Associates of New Orleans! They were booked up but got me in immediately to be seen. They stayed late after hours to ensure I was properly diagnosed. After examination and discussion of my medical history, Dr. Ta was able to properly diagnose and aggressively treat me. “She was kind and compassionate and took the time to listen to all of my concerns and explain what was happening and what they were going to do. If it wasn’t for her fast action and quick decisions, I would be permanently blind.” When asked about Adam’s initial visit, Dr. Ta says: “The first time I met Mr. Diaz, he understandably was very fearful of losing his vision. He only had one seeing
I n side N ew Orl ean s
eye, as he had lost vision in his other eye at a young age due to a retinal detachment. Along with eye redness, photosensitivity, and seeing floaters, he explained to me that his peripheral vision had rapidly deteriorated over a matter of days. On examination, Mr. Diaz had severe inflammation in the posterior segment of his eye with peripheral retinal whitening, which alerted me to the possibility that this could be an underlying viral infection of the retina. “I suspected Acute Retinal Necrosis (ARN), which is characterized by retinal whitening, typically beginning in the peripheral retina, and can rapidly become more and more confluent until it spreads towards the patient’s central vision, as in Mr. Diaz’s case. There is typically also inflammation of the retinal arterioles, which can lead to occlusion and further vision loss.” Dr. Ta quickly leaped into action to help Adam’s condition. “Based on my clinical suspicion of ARN, I immediately started Mr. Diaz on oral antivirals while I waited on lab results to rule out other potential diagnoses. I also took a small sample of aqueous fluid, or fluid from the front of the eye, and sent this for viral polymerase chain reaction (PCR) to rapidly determine the causative virus. Shortly after, I treated him with an intravitreal antiviral, or an injection of antiviral medication into the eye, and started him on steroid eyedrops to alleviate the inflammation. “Treatment of ARN traditionally involved hospitalizing patients with IV antivirals, but more recently, newer oral antiviral agents, along with intravitreal injections, have allowed retinal specialists to effectively manage this complex condition in an outpatient setting. Prompt initiation of antiviral treatment, both with oral antivirals and/or intravitreal antivirals, can halt progression of the retinitis, or retinal infection, within days to weeks. Another concern is that after resolution of the infection, rhegmatogenous retinal detachment is a common potential complication. This occurs in about 75 percent of eyes with ARN and may develop weeks to months after initial presentation of the infection. “In order to prevent vision loss from a
photo courtesy: ADAM DIAZ
Condition: Acute Retinal Necrosis Treatment: Antiviral Medication, Retinal Laser Photocoagulation, and Pneumatic Retinopexy
