Acute retinal necrosis: a case series with clinical features and treatment outcomes
- 12 July 2009
- journal article
- Published by Wiley in Clinical & Experimental Ophthalmology
- Vol. 37 (5), 473-477
- https://doi.org/10.1111/j.1442-9071.2009.02083.x
Abstract
To determine clinical features, viral aetiology and treatment outcomes of eyes with acute retinal necrosis (ARN). Retrospective, interventional, non-comparative case series. Twenty-two patients (23 eyes) were identified between 1996 and 2007. Varicella zoster virus was the causative agent in 12 patients (nine confirmed by polymerase chain reaction), herpes simplex virus type 1 in six (five polymerase chain reaction-confirmed) and unknown in three patients. Five patients had documented herpes zoster infection in the month prior to the onset of ARN. Twelve patients (55%) had identifiable (clinical or subclinical) immune dysfunction. At 6 months, 3 out of 15 eyes (20%) maintained vision 6/12 or better and 7 (47%) were 6/60 or worse. Median final VA was 6/60. Nine eyes developed retinal detachment and two-thirds of these had received prior barrier laser. Poor prognostic factors for severe visual loss by univariate analysis were male gender (P = 0.019), and the development of retinal detachment (P = 0.05). Delay between onset of symptoms and diagnosis was associated with moderate visual loss (P = 0.018). Barrier laser did not reduce the risk of retinal detachment. Acute retinal necrosis still has poor visual prognosis. Early diagnosis and initiation of treatment may improve outcome.Keywords
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