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Acute Retinal Necrosis: A Multicenter Study on Factors Associated with Visual Outcomes and Retinal Detachment
Panuwat Soitong1, Yaninsiri Ngathaweesuk1, Noppakhun Panyayingyong2
1Ocular Inflammation and Infection Division, Department of Ophthalmology, Phramongkutklao College of Medicine, Bangkok, Thailand.
Ocular Immunology and Inflammation
|February 14, 2025
Summary
Severe visual impairment and retinal detachment are common in acute retinal necrosis (ARN). Key risk factors include zone 1 involvement, immunocompromised status, and detachment, necessitating early intervention, especially in VZV-ARN cases.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Retinal Diseases
Background:
- Acute retinal necrosis (ARN) is a severe viral retinitis.
- Visual impairment and retinal detachment (RD) are significant complications of ARN.
Purpose of the Study:
- To evaluate visual outcomes in ARN patients.
- To identify viral pathogens and risk factors for severe visual impairment (SVI) and RD in ARN.
Main Methods:
- Retrospective multicenter cohort study.
- Aqueous or vitreous PCR testing for viral pathogens.
- Multivariable regression models for SVI and RD risk factors.
Main Results:
- 47.7% of ARN patients experienced SVI (visual acuity ≤20/200).
- SVI associated with zone 1 involvement, immunocompromised status, and RD.
- RD occurred in 35.4% of cases, with higher incidence in VZV-ARN and specific retinitis patterns.
Conclusions:
- Zone 1 involvement, immunocompromised status, and RD are key risk factors for SVI.
- RD is a frequent complication, occurring in about one-third of ARN cases.
- Early, aggressive intervention is crucial for VZV-ARN, particularly in extensive retinitis and immunocompetent patients.
