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Initial treatment with acyclovir and valacyclovir failed, and involvement of the other eye suggested a resistant variant of varicella zoster virus. High-dose oral famciclovir therapy resulted in rapid resolution of ARN in both eyes. This case highlights the rare occurrence of choroiditis, the novel finding of VHRS, and the potential utility of high-dose oral famciclovir in treating refractory ARN.<\/jats:p>","DOI":"10.4103\/ijo.ijo_894_24","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T13:00:18Z","timestamp":1723640418000},"page":"S2-S6","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Refractory acute retinal necrosis presenting as peripapillary choroiditis \u2013 A diagnostic and therapeutic challenge"],"prefix":"10.4103","volume":"73","author":[{"given":"Ankush","family":"Kawali","sequence":"first","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai Bhakti","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padmamalini","family":"Mahendradas","sequence":"additional","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"R1-20260424","first-page":"1","article-title":"Choroidal involvement and chronic macular edema in acute retinal necrosis: A novel finding and a novel treatment. 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