Acute Retinal Necrosis: Signs, Treatment, Complications and Outcome

Area of Science:

• Ophthalmology
• Infectious Diseases
• Virology

Background:

• Acute Retinal Necrosis (ARN) is a severe, rapidly progressing necrotizing retinitis and vasculitis.
• Commonly caused by Varicella-Zoster-Virus (VZV), Herpes-Simplex-Virus (HSV), Cytomegalovirus (CMV), and Epstein-Barr-Virus (EBV).
• Diagnosis relies on clinical signs including retinal necrosis, rapid progression, vasculopathy, and intraocular inflammation.

Purpose of the Study:

• To evaluate treatment outcomes and complications in patients with ARN.
• To assess the impact of vitrectomy on visual acuity in ARN cases.
• To highlight the importance of early detection and intervention, particularly in bilateral cases.

Main Methods:

• Retrospective analysis of 16 eyes from 10 ARN patients.
• Evaluation of corrected distance visual acuity (CDVA), intraocular pressure (IOP), pathogen identification, therapy, and complications.
• Comparison of outcomes between eyes that underwent vitrectomy and those that did not.

Main Results:

• Pathogen identified in nine patients (VZV, HSV, CMV, EBV).
• Vitrectomy was performed in nine eyes, with a decrease in CDVA post-procedure.
• Eyes without vitrectomy showed better visual acuity outcomes compared to vitrectomized eyes.
• Complications included retinal detachment, disease recurrence, and hypotony.

Conclusions:

• Early diagnosis and treatment of ARN, especially in fellow eyes, lead to more successful outcomes.
• The efficacy of vitrectomy is challenging to assess due to its performance in advanced disease stages.
• Prompt and appropriate treatment is essential to prevent irreversible vision loss in ARN patients.