Long-term follow-up of acute retinal necrosis.
OBJECTIVE
The purpose of this study was to report long-term visual outcome of acute retinal necrosis.


METHODS
Medical records of patients with acute retinal necrosis were reviewed.


RESULTS
Thirty-two patients were diagnosed with acute retinal necrosis from 1998 to 2007. Twenty patients (25 eyes) had at least 1 follow-up and available medical records. Intravitreal injections of ganciclovir and/or foscarnet were administered in 11 of 25 eyes. Intravenous and oral antiviral medications were used in 14 of 20 and 19 of 20 patients, respectively. Eleven of 25 eyes had <25% of retina affected, 8 of 25 had 25% to 50% of retina affected, and 6 of 25 had >50% of retina affected. Mean visual acuity at all time points was best when retinitis involved <25% and decreased as area increased. All but 1 eye with >50% involvement experienced decreased vision regardless of treatment. Three of 4 eyes with 25% to 50% involvement that received intravitreal antivirals had an improvement in visual acuity of > or =2 Snellen lines. Five of 25 eyes developed retinal detachment. None of the six eyes treated with prophylactic laser detached.


CONCLUSIONS
Greater extent of retinitis portends a worse visual prognosis. Although intravitreal treatment did not prevent visual acuity loss in patients with severe disease, patients with moderate disease (25-50% retina involved) did well with intravitreal therapy with most having stable or improved visual acuity. Prophylactic laser decreased the rate of detachment.
Meghpara
Beeran
B
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.
Sulkowski
Gregory
G
Kesen
Muge R
MR
Tessler
Howard H
HH
Goldstein
Debra A
DA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D002648:Child; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D004359:Drug Therapy, Combination; D015828:Eye Infections, Viral / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D017245:Foscarnet / Q000008:administration & dosage; D015774:Ganciclovir / Q000008:administration & dosage; D006561:Herpes Simplex / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D006562:Herpes Zoster / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D015882:Retinal Necrosis Syndrome, Acute / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D012189:Retrospective Studies; D018139:Simplexvirus / Q000302:isolation & purification; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body / Q000821:virology
D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir