[Clinical features of acute retinal necrosis at Hokkaido University Hospital]

To study clinical features of acute retinal necrosis (ARN) at Hokkaido University Hospital.

Twenty-one eyes of 19 patients with ARN (10 male and 9 female patients) who were treated at Hokkaido University Hospital between 1992 and 2006 were retrospectively examined from clinical records.

The average age of the patients was 53.4 years (range, 13 to 91 years). 17 cases were unilateral and 2 were bilateral. The pathogenic virus was herpes simplex virus-1 (HSV-1) in 2 patients, and varicella-zoster virus (VZV) in 17 patients. Clinical severity was assessed from spreading speed and area of the retinal exudation, and 5 eyes were judged as fulminant cases (4 VZV eyes, 1 HSV eye), 6 eyes as severe cases (6 VZV eyes), and 10 eyes as mild cases (9 VZV eyes, 1 HSV eye). The range of retinal exudation was 1 to 2 quadrants in 7 eyes, 3 to 4 quadrants in 3 eyes, and increased to all quadrants in 11 eyes. Retinal detachment (RD) was observed in 8 eyes (38%), and the final visual acuity was less than 0.1 in 9 eyes (43%).

The leading cause of ARN at Hokkaido University Hospital was VZV, and no HSV-2 ARN was seen. Compared with other areas in Japan, ARN at Hokkaido University Hospital seems to show less frequent RD, but the same prognosis for final visual acuity.