Bilateral acute retinal necrosis with choroidal detachment

A 42-year-old man with history of topiramate intake presented with sudden diminution of vision. He was diagnosed with bilateral panuveitis with retinitis and serous choroidal detachment, with ultrasound biomicroscopy revealing ciliary body effusion. Systemic investigations were negative for immunosuppression. Topiramate was stopped and the patient was started on oral valacyclovir and oral steroids 48 h after antiviral therapy. The patient responded well to the treatment leading to resolution of retinitis as well as choroidal detachment. This is a unique case of bilateral acute necrotizing retinitis and choroidal detachment, in which early recognition and prompt treatment led to a favorable outcome.