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Acute retinal necrosis: an assessment of vitreous and retinal detachment
Yosuke Arai1, Hideo Akiyama2, Shunsuke Tokui1
1Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Purpose:
To examine the relationship between posterior vitreous changes and retinal detachment (RD) associated with acute retinal necrosis (ARN).
Study Design:
Retrospective, consecutive case study.
Methods:
This study evaluated the clinical findings for 32 eyes of 29 patients (12 women, 17 men) diagnosed with ARN, with the posterior vitreous condition monitored by swept-source optical coherence tomography (SS-OCT). The causative virus, incidence of RD, and relationship between the development of RD and final visual acuity were investigated. Patients were checked for posterior vitreous detachment (PVD) from the initial visit to the last SS-OCT observation.
Results:
Varicella-zoster virus caused 67% of the ARN cases, with RD developing in 66% of the cases, and proliferative vitreoretinopathy (PVR) in 90% at onset or at recurrence. Silicone oil could not be removed in 38% of the cases with RD. Final best-corrected visual acuity was significantly worse in the RD (+) group than in the RD (-) group (median logMAR 1.02 vs. 0.16, p = 0.04). PVD occurred in 20 of 21 eyes without PVD at the initial examination, with 18 of these 20 eyes developing RD (90%). PVD occurred at an average of 45.8 ± 32.1 days after the initial examination, with 85% of the cases developing PVD within 3 months.
Conclusions:
The visual prognosis of ARN complicated by RD is poor. PVD is involved in the development of RD and is often associated with PVR, which itself is refractory.
