Therapy for acute retinal necrosis.
Acute retinal necrosis is a progressive necrotizing retinopathy caused by herpes simplex virus (HSV) or varicella zoster virus (VZV). The mainstay of its treatment is antiviral therapy against these pathogenic organisms, such as intravenous acyclovir or oral valacyclovir. Systemic and topical corticosteroids together with antiviral therapy are used as an anti-inflammatory treatment to minimize damages to the optic nerve and retinal blood vessels. Because the majority of severe cases of the disease show occlusive retinal vasculitis, a low dosage of aspirin is used as anti-thrombotic treatment. Vitreo-retinal surgery is useful to repair rhegmatogenous retinal detachment, one of the main late-stage complications. Moreover, recent articles have reported some encouraging results of prophylactic vitrectomy before rhegmatogenous retinal detachment occurs. The efficacy of laser photocoagulation to prevent the development or extension of rhegmatogenous retinal detachment is controversial. Despite these treatments, the visual prognosis of acute retinal necrosis is still poor, in particular VZV-induced acute retinal necrosis.
Kawaguchi
Tatsushi
T
Department of Ophthalmology & Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
Spencer
Doran B
DB
Mochizuki
Manabu
M
D000998:Antiviral Agents / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006561:Herpes Simplex / Q000628:therapy* / Q000821:virology; D006563:Herpes Zoster Ophthalmicus / Q000628:therapy* / Q000821:virology; D006801:Humans; D017075:Laser Coagulation; D011379:Prognosis; D015882:Retinal Necrosis Syndrome, Acute / Q000628:therapy* / Q000821:virology; D014821:Vitrectomy
D000998:Antiviral Agents; D005343:Fibrinolytic Agents; D005938:Glucocorticoids