title: Pattern of Acute Retinal Necrosis in a Referral Center in Tunisia, North Africa.
abstract: OBJECTIVE
  To describe the pattern of acute retinal necrosis (ARN) syndrome in a referral center in Tunisia.
  
  
  METHODS
  Retrospective review of the charts of 12 patients (12 eyes).
  
  
  RESULTS
  Necrotizing retinitis involved >50% of the retina in 33.3% of eyes. Polymerase chain reaction on aqueous humor sample identified herpes simplex virus-1 in 4 eyes (33.3%) and varicella zoster virus in 3 eyes (25%), and was negative in 5 eyes (41.7%). All patients received intravenous acyclovir, followed by oral antivirals. Follow-up ranged from 6 to 16 months. Retinal detachment (RD) occurred in 3 eyes (25%), but no patient developed bilateral ARN. Final visual acuity was 20/200 or worse in 7 eyes (58.3%). Delay in diagnosis (p = 0.015), macular involvement (p = 0.045), development of RD (p = 0.018), and 25-50% of retinal involvement (p = 0.045) were associated with a worse visual outcome.
  
  
  CONCLUSIONS
  ARN carries poor visual prognosis in Tunisia.
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Sana
authors.initials: S
authors.lastname: Khochtali
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Nesrine
authors.initials: N
authors.lastname: Abroug
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Rim
authors.initials: R
authors.lastname: Kahloun
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Imen
authors.initials: I
authors.lastname: Ksiaa
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Imen
authors.initials: I
authors.lastname: Nahdi
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Zaouali
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Salim
authors.initials: S
authors.lastname: Ben Yahia
authors.affiliation: a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia.
authors.forename: Moncef
authors.initials: M
authors.lastname: Khairallah
mesh_terms: D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D018259:Herpesvirus 1, Human / Q000235:genetics; D014645:Herpesvirus 3, Human / Q000235:genetics; D006801:Humans; D015994:Incidence; D008297:Male; D012017:Referral and Consultation; D015882:Retinal Necrosis Syndrome, Acute / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D012189:Retrospective Studies; D014416:Tunisia
chemical_list: D004279:DNA, Viral
keywords: Acute retinal necrosis; North Africa; herpes simplex virus; herpes zoster virus; polymerase chain reaction; retinal detachment