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Acute Retinal Necrosis: Experience in a Reference Center in Santander - Colombia.

Carlos Mario Rangel1,2,3, Marcos Restrepo-Arango4, Germán Mejía-Salgado5

  • 1Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Santander, Colombia.

Ocular Immunology and Inflammation
|August 15, 2023
PubMed
Summary

Prompt treatment for acute retinal necrosis (ARN) is essential for preserving vision. This case series highlights effective antiviral strategies and their impact on visual outcomes in ARN patients.

Keywords:
Acute retinal necrosisHerpes simplexintravenous acycloviroral valacyclovirretina

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Virology

Background:

  • Acute retinal necrosis (ARN) is a severe ocular condition requiring urgent intervention to prevent vision loss.
  • Early administration of antiviral medications and corticosteroids is critical for achieving favorable visual outcomes in ARN patients.

Purpose of the Study:

  • To present a case series detailing the treatment experience and outcomes for patients diagnosed with acute retinal necrosis.
  • To evaluate the effectiveness of different antiviral treatment regimens in managing ARN.

Main Methods:

  • Patients diagnosed with ARN according to SUN Working Group 2021 criteria were included in this study.
  • Diagnostic procedures involved comprehensive eye examinations, polymerase chain reaction (PCR) analysis, and imaging studies.
  • Treatment involved induction therapy with oral valacyclovir or intravenous acyclovir, followed by a six-month maintenance regimen including oral antivirals and intravitreal ganciclovir.

Main Results:

  • Six out of eight patients had ARN confirmed by PCR.
  • Induction therapy consisted of oral valacyclovir (5/8) or intravenous acyclovir (3/8) for 10-14 days.
  • Maintenance therapy included oral valacyclovir (6/8) or oral valganciclovir (2/8) for six months, alongside intravitreal ganciclovir.
  • Visual outcomes were comparable between oral and intravenous induction therapies. Baseline visual acuity and macular involvement were associated with poorer final visual acuity.

Conclusions:

  • Prompt initiation of treatment is paramount in managing acute retinal necrosis.
  • The findings underscore the importance of effective treatment strategies in influencing the visual prognosis of ARN.