Purchase this article with an account.
Shriji Patel, Ronald J Rescigno, Marco Zarbin, Paul D Langer, Neelakshi Bhagat; Clinical characteristics of acute retinal necrosis: an 8-year review. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2848.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe the demographics, characteristics and management of eyes with acute retinal necrosis (ARN).
Retrospective chart review of patients with ARN that presented to University Hospital (UH), New Jersey Medical School between January 2005 and December 2012.
Fourteen patients presented with a clinical diagnosis of acute retinal necrosis. Seven of 14 patients (50%, 21 eyes total) had bilateral involvement on presentation. Average age was 51 years (26-80), 12 were males. Four patients were HIV positive and four patients were immunocompromised due to other coexisting medical problems. Vision on presentation in the affected eye ranged from 20/40 to no light perception; the majority of patients presented with 20/400 vision or worse. Thirteen patients were admitted for intravenous acyclovir treatment, average of 11 days of inpatient stay. Seven eyes underwent aqueous sampling, five eyes underwent vitreous biopsy. Seven of twelve samples returned positive for herpes simplex virus (HSV), four for HSV type 1, three for HSV type 2. One of twelve samples returned positive for varicella-zoster virus (VZV). All eyes received intravitreal ganciclovir injection (2.4mg/0.1cc) +/- foscarnet injection (2.0mg/0.1cc), 13 eyes underwent multiple treatments or ganciclovir implant placement. Thirteen eyes required rhegmatogenous retinal detachment repair. Upon conclusion of intravenous acyclovir treatment, all patients were started on oral antiviral treatment consisting of acyclovir or valaciclovir for a minimum of six weeks. Final best-corrected visual acuity (BCVA) ranged from 20/25 to NLP; 15 of 21 eyes (71%) had vision of 20/200 or worse.
We reviewed 21 eyes of 14 patients with acute retinal necrosis. Half of the patients in our study had bilateral involvement, over 70% of eyes had final BCVA of 20/200 or worse. There is a high degree of ocular morbidity associated with acute retinal necrosis.
This PDF is available to Subscribers Only