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Bárbara M. Elizondo Fernández, Uriel Moreno Páramo, Luz Elena Concha del Río, Lourdes Arellanes García; Acute Retinal Necrosis: A case series. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1504.
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© ARVO (1962-2015); The Authors (2016-present)
Acute Retinal Necrosis (ARN) is a rare but devastating ocular disease. A retrospective observational study was performed to present a case series of twelve patients diagnosed clinically with ARN.
Our institution’s database was reviewed and records of patients with a clinical diagnosis of ARN between February 2006 and February 2016 were included in this study. Patients with a follow-up of less than six months were excluded. Demographic and clinical data were obtained, and disease course, treatment and complications were also analyzed.
Twelve patients, a total of fifteen eyes, with a diagnosis of ARN were studied; 25% of the cases were bilateral. The mean age of presentation was 48 years, 42% were male and 58% female. The most common presenting symptom was a decrease in visual acuity (91%). Thirty-three percent of our patients had a visual acuity of 20/60 or better, 27% were between 20/80 and 20/400 and 40% of them had an acuity of 20/800 or worse. All cases were found to have peripheral retinal vasculitis. The average time to retinitis inactivation in patients who received intravenous and oral Acyclovir was 8.2 weeks; the outcome is very similar to those treated with intravenous Acyclovir and oral Valacyclovir who achieved inactivation at 7.6 weeks. A rhegmatogenous retinal detachment complicated 46% of the cases, it occurred on average 3.6 months after the initial symptoms. Five eyes (33%) had a final visual acuity better than 20/40, none of these had retinal detachment; three eyes (20%) ended up with a visual acuity between 20/50 and 20/150 and the remaining seven eyes (47%) had an acuity of 20/800 or worse.
ARN has a poor visual prognosis, mainly due to the high incidence of rhegmatogenous retinal detachment. In these cases complicated with retinal detachment, vitrectomy with silicone oil tamponade is considered the best surgical option. A timely diagnosis of ARN and early systemic treatment are key in limiting the damage, preventing complications and avoiding contralateral eye involvement.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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