What is your approach to antiviral treatment of HSV acute retinal necrosis?

Acute Retinal Necrosis (ARN) is a rapidly progressive syndrome usually caused by varicella-zoster virus (VZV)and herpes simplex virus 1 or 2 (HSV). The syndrome is rapidly progressive in the absence of antiviral treatment. PCR performed on aqueous or vitreous sampling is highly sensitive and strongly recommended for viral Dx. However, antiviral treatment should begin as soon as the clinical diagnosis is made without waiting for PCR results. Acyclovir IV had been the primary antiviral of choice for induction. Hospitalization and induction with IV medications are usually reserved for patients unable to take oral medications, in patients with presumed systemic viral infection with HSV or VZV or in immunosuppressed patients (Lains & Eliott, PMI...