[Treatment of acute retinal necrosis: systematic review].
OBJECTIVE
The purpose of this study was to identify, according to an systematic review, the best treatment for acute retinal necrosis.


METHODS
Following the methodologic guidance of the Cochrane Collaboration and its editorial subgroup "Eye and Vision Group", using search strategy for study identification, articles about the treatment of acute retinal necrosis were selected.


RESULTS
146 bibliographic references were selected, 13 studies were considered relevant. Among them 2 were considered to follow the inclusion criteria. The first study tested the possibility of using intravenous acyclovir associated with corticosteroids, protecting contralateral eye from being affected. Fifty-four patients who reported unilateral acute retinal necrosis have been studied, 31 treated and 23 not treated, the disease occurring in the contralateral eye in 12.9% of the patients of the treated group and in 69.5% of the patients in the non-treated group. The second study considered treatment with photocoagulation with argon laser to prevent retinal detachment, that was observed in 57.1% of the eyes. The second included study disclosed 19 eyes affected by acute retinal necrosis, considering that 12 of these eyes were treated with photocoagulation with argon laser to prevent retinal detachment. Among the 12 eyes, 2 developed retinal detachment (16.6%) while, in the non-treated group, 7 eyes, 4 developed retinal detachment (57.1%).


CONCLUSIONS
The author concludes that both types of proposed interventions have proven to be effective. However, once the mentioned studies are methodologically considered weak, it is necessary to perform randomized clinical trials with the purpose of establishing the most suitable treatment for acute retinal necrosis.
Zajdenweber
Moysés Eduardo
ME
Departamento de Oftalmologia, Universidade Federal de São Paulo, São Paulo, SP. moysesz@uol.com.br
Muccioli
Cristina
C
D000212:Acyclovir / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D016001:Confidence Intervals; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D015882:Retinal Necrosis Syndrome, Acute / Q000188:drug therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000212:Acyclovir