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Published on: September 11, 2013
Retinal detachment in patients with acute retinal necrosis: a case series
M Abegg1, M Kurz-Levin, H Helbig
1Department of Ophthalmology, University Hospital Zurich, Switzerland. mhabegg@hispeed.ch
Background:
Acute retinal necrosis is a rare and severe infectious ocular disease frequently complicated by retinal detachment.
Patients And Methods:
Records of six consecutive eyes from five patients with acute retinal necrosis were reviewed.
Results:
PCR analysis of intraocular fluids was positive for Varizella zoster virus, Herpes virus 1 or 2. Treatment consisted of systemic acyclovir, systemic and local corticosteroids as well as aspirin. Progression of the necrosis could be effectively controlled, however all eyes developed retinal detachment within 55 +/- 24 days. Retinal surgery including pars plana vitrectomy, encircling scleral buckling, liquid silicone or gas filling led to retinal reattachment in all patients during the follow-up time (590 +/- 242 days). The mean visual acuity at the end of the follow-up time was 0.4 +/- 0.3.
Conclusions:
The diagnosis of acute retinal necrosis is reliably confirmed using PCR analysis of intraocular fluids. Currently available treatments are effective in stopping progression of the necrosis. There is, however, a high risk of retinal detachment, which can be successfully treated with vitreoretinal surgery.
