Surgical management of retinal detachment secondary to acute retinal necrosis: clinical features, surgical techniques, and long-term results.
OBJECTIVE
To describe the clinical features of complicated retinal detachment secondary to acute retinal necrosis (ARN) and to present the long-term results of vitreous surgery in these cases.


METHODS
A retrospective study was conducted on 16 immunocompetent patients (18 eyes). The average follow-up period was 60 months.


RESULTS
Proliferative vitreoretinopathy (PVR) grade C, with the predominance of anterior PVR, and characteristic changes in the vitreous base area were present in all cases before surgery. All eyes underwent vitrectomy, membrane peeling, endolaser photocoagulation, and intraocular tamponade without scleral buckling. Additional procedures were performed in 13 eyes. Retinal reattachment was achieved in the 18 eyes (100%) in the short term. Variable degrees of reproliferation occurred in all cases after surgery. Other delayed complications included ocular hypotony, macular pucker, peripheral retinal neovascularization, and severe preretinal fibrosis. Improvement of visual acuity occurred in 13 eyes (72.2%). Eleven eyes (61.1%) achieved final ambulatory visual acuity of 5/200 or better.


CONCLUSIONS
Rhegmatogenous retinal detachment secondary to ARN has characteristic clinical features. Severe proliferative vitreoretinopathy with the predominance of anterior PVR develops rapidly. Reproliferation is the most important late postvitrectomy complication necessitating multiple surgical procedures in these cases. The visual results remain unfavorable due to the destructive nature of ARN.
Ahmadieh
Hamid
H
Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Soheilian
Masoud
M
Azarmina
Mohsen
M
Dehghan
Mohammad H
MH
Mashayekhi
Arman
A
D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D015882:Retinal Necrosis Syndrome, Acute / Q000150:complications*; D012167:Retinal Perforations / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods; D018630:Vitreoretinopathy, Proliferative / Q000209:etiology / Q000473:pathology