Isolated unilateral acute retinal necrosis syndrome as the initial manifestation of HIV infection.

We report a rare case of isolated unilateral acute retinal necrosis syndrome without any history of associated herpes zoster or other conditions attributed to HIV infection as the initial manifestation of HIV infection. A 30-year-old man presented with a history of sudden diminished vision in the right eye with no apparent predisposing factors. Examination revealed right eye acute retinal necrosis. All laboratory test results were normal except the patient tested positive for HIV. This case of an atypical ophthalmic manifestation as initial presentation of HIV infection highlights the need for increased index of suspicion for HIV infection in young patients with acute retinal necrosis syndrome.