Acute retinal necrosis: clinical features, management and outcomes


Ozdemir Yalcinsoy K., Cakar Ozdal P., Inanc Tekin M., KARATEPE M. S., Ozdamar Erol Y.

International Ophthalmology, vol.43, no.6, pp.1987-1994, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 43 Issue: 6
  • Publication Date: 2023
  • Doi Number: 10.1007/s10792-022-02598-7
  • Journal Name: International Ophthalmology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE
  • Page Numbers: pp.1987-1994
  • Keywords: Acute retinal necrosis, Occlusive vasculitis, Antiviral therapy, Retinal detachment, Laser photocoagulation, Vitrectomy
  • Sivas Cumhuriyet University Affiliated: Yes

Abstract

© 2022, The Author(s), under exclusive licence to Springer Nature B.V.Purpose: To evaluate the clinical features, treatment, and visual outcome of patients with acute retinal necrosis (ARN). Methods: The data of patients were retrospectively reviewed. Factors associated with visual loss and factors affecting the risk for retinal detachment (RD) development were evaluated. Results: Twenty-four eyes of 24 patients (7 female/17 male, mean age 43.7 years, mean follow-up period 31.0 months) were included. In ocular fluid samples of 15 (83%) out of 18 eyes, polymerase chain reaction (PCR) tests were positive for herpes simplex virus (seven eyes; 39%), varicella zoster virus (six eyes; 33%), cytomegalovirus (one eye; 6%), and adenovirus (one eye; 6%). Central retinal occlusive vasculitis was observed in three (13%) eyes. Systemic antiviral therapy was given to all patients, and additional intravitreal ganciclovir was administered in seven eyes (29%). The most common complication was RD (46%). There was no statistically significant difference in the frequency of RD between herpes simplex virus- and varicella zoster virus-positive patients (p =.617). The rate of RD was similar in eyes undergoing prophylactic laser photocoagulation (LPC), eyes undergoing vitrectomy + LPC, and eyes not undergoing LPC (p =.237). The number of eyes with final visual acuity below 20/200 was significantly higher in eyes with RD than without RD (p =.047). Conclusion: Prophylactic LPC and vitrectomy did not show clear benefits in terms of preventing RD development. RD was the most common complication and a major factor for a poor visual prognosis.