{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:07:52Z","timestamp":1779250072602,"version":"3.51.4"},"reference-count":17,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,5,6]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>This case describes a mid-adolescent male with a history of B-cell acute lymphocytic leukaemia (B-cell ALL) t(1;19) positive hyperdiploidy, a high-risk variant, who developed bilateral acute necrotising retinitis and frosted branch angiitis, presenting with bilateral severe vision loss. Despite prompt intravitreal and systemic antiviral therapy, his condition worsened, leading to subretinal exudation, retinal traction and combined mechanism retinal detachment in both eyes. Systemic workup, including cerebrospinal fluid analysis with no malignant cells and neuroimaging without central nervous system infiltration, ruled out leukaemia recurrence, thus localising disease to the retina. The report highlights the challenges of managing active disease surgically and details the use of extensive retinectomy to remove fibrovascular tissue. Multiple staged surgeries successfully reattached the retinas with limited functional outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2025-267628","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:19:55Z","timestamp":1779247195000},"page":"e267628","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Viral necrotising retinitis with frosted branch angiitis: rapid progression into bilateral combined retinal detachment \u2014 a management challenge"],"prefix":"10.1136","volume":"19","author":[{"given":"Kanika","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rama Tulasi Siri","family":"Duddumpudi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priti","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6991-4746","authenticated-orcid":false,"given":"Samendra","family":"Karkhur","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"2026051905550979000_19.5.e267628.1","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1007\/s10792-023-02656-8","article-title":"First-line management of necrotizing herpetic retinitis by prioritizing the investigation of immune status and prognostic factors for poor visual outcomes","volume":"43","author":"Loubsens","year":"2023","journal-title":"Int Ophthalmol"},{"key":"2026051905550979000_19.5.e267628.2","doi-asserted-by":"publisher","DOI":"10.1097\/00006982-199709000-00002"},{"key":"2026051905550979000_19.5.e267628.3","first-page":"663","article-title":"Standard diagnostic criteria for the acute retinal necrosis syndrome","volume":"117","author":"Holland","year":"1994","journal-title":"Am J"},{"key":"2026051905550979000_19.5.e267628.4","first-page":"1871","article-title":"Use of multiplex PCR and real-time PCR to detect viruses in aqueous humor in patients with uveitis","volume":"118","author":"Shimizu N,","year":"2011","journal-title":"Ophthalmology"},{"key":"2026051905550979000_19.5.e267628.5","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.ajo.2021.03.051","article-title":"Classification Criteria for Cytomegalovirus Retinitis","volume":"228","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"2026051905550979000_19.5.e267628.6","doi-asserted-by":"publisher","DOI":"10.1001\/pubs.Ophthalmol.-ISSN-0003-9950-119-1-ecs90308"},{"key":"2026051905550979000_19.5.e267628.7","unstructured":"Kasetty VM , Sethi D , Gelman E , et al . 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