Purpose: To report a case of progressive outer retinal necrosis treated by combined intravitreal foscarnet and ganciclovir. Case summary: A 11-year-old male with a history of chemotherapy and cord blood transplantation due to precursor T-cell leukemia developed Herpes zoster lesion on his forehead and rapidly progressing peripheral retinal necrosis without vasculitis in the right eye. Varicella-Zoster virus was confirmed in his cerebrospinal fluid using polymerase chain reaction (PCR); and the

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... atient was diagnosed with progressive outer retinal necrosis. Despite combined treatment with intravenous acyclovir and foscarnet and intravitreal foscarnet, retinal necrosis progressed to retinal detachment and total retinal necrosis. During follow-up, new retinal necrosis was observed in his left eye. The patient was started on combined intravenous and intravitreal foscarnet and ganciclovir; retinal necrosis in the left eye regressed and posterior pole was spared. With subsequent oral valganciclovir and intravitreal foscarnet and ganciclovir, the remaining retina was preserved with maintained vision. J Korean Ophthalmol Soc 2015;56 (6) :967-974 진행성외망막괴사는 1990년 Forster et al 1 에 의해 처음 보 고된 괴사성 망막염으로 당시에는 후천성면역결핍증 환자 들에게만 특징적으로 발생하는 바이러스 망막염으로 생각 되었다. 이후 Engstrom et al 2 은 진행성외망막괴사의 진단기 준으로 여러 개의 혼탁한 망막 괴사 병변이 때로 융합되어 주변부 망막에 깊게 나타나며, 매우 빠르게 진행하며 황반을 침범하기도 하나, 혈관염은 보이지 않고 안내염증 반응은 거 의 없거나 미미하다고 하였다. 이후 여러 면역조직화학 연구 의 결과로 진행성외망막괴사의 원인 바이러스로 Varicella-Zoster Virus (VZV)가 지목되었다. 3,4 VZV는 헤르페스 바이