Abstract
Figure 1. A 45-year-old man with a biopsy-proven pineal tumor was on the seventh day of his first cycle of chemotherapy when symptoms of meningeal irritation and confusion developed. Polymerase chain reaction of cerebrospinal fluid revealed herpes simplex virus type 2, and after acyclovir treatment he appeared to make a complete recovery. However, during his third cycle of chemotherapy, he had severe visual loss, and the diagnosis of bilateral acute retinal necrosis was made. Despite therapy, retinal detachment and ischemic optic neuropathy ensued, and the patient was left with no light perception bilaterally.
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