April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Long-term Visual Outcome Of Patients Presenting With Necrotizing Viral Retinopathies
Author Affiliations & Notes
  • Fernando A. Esposito
    Ophthalmology, Hopital Pitie Salpetriere, Paris, France
  • Ghislaine Ducos
    Ophthalmology, Hopital Pitie Salpetriere, Paris, France
  • Thi Tran
    Ophthalmology, Hopital Pitie Salpetriere, Paris, France
  • Nathalie Cassoux
    Ophthalmology, Hopital Pitie Salpetriere, Paris, France
  • Christine Fardeau
    Ophthalmology, Hopital Pitie Salpetriere, Paris, France
  • Phuc Lehoang
    Ophthalmology, Hopital Pitie Salpetriere, Paris, France
  • Bahram Bodaghi
    Ophthalmology, Hopital Pitie Salpetriere, Paris, France
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4268. doi:
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      Fernando A. Esposito, Ghislaine Ducos, Thi Tran, Nathalie Cassoux, Christine Fardeau, Phuc Lehoang, Bahram Bodaghi; Long-term Visual Outcome Of Patients Presenting With Necrotizing Viral Retinopathies. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4268.

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Abstract

Purpose: : To determine the long-term visual outcome of patients presenting with a Necrotizing Viral Retinopathy (NVR), according to clinical characteristics, virological findings, complications and therapeutic management.

Methods: : The files of patients referred to our Department between may 1997 and may 2000 for the therapeutic management of a NVR were retrospectively reviewed. Diagnosis of NVR was performed using the PCR- analysis of ocular fluids and response to antiviral therapy. We analyzed findings at initial examination, medical history, clinical evolution under treatment, complications and final visual acuity.

Results: : 20 patients (24 eyes) were retrospectively reviewed, including 10 men and 10 women with a mean follow-up of eight years (range 5-13 y). Final visual acuity ranged from light perception to 20/20. The most frequent acute complication was necrosis progression requiring aggressive antiviral therapy. We also observed delayed complications challenging visual outcomes with a retinal detachment (9 eyes), a chronic vitritis with macular edema (9 eyes), an optic atrophy (5 eyes), an epimacular membrane (6 eyes), a viral relapse (2 eyes) or a phtysis bulbi (3 eyes). At the last examination, 17 patients had a long-term low dose antiviral ttherapy. Poor visual outcome was associated with an extensive area of retinal necrosis at referral, an HSV-2 or VZV infection and the misuse of systemic corticosteroids.

Conclusions: : Several years after being diagnosed with a NVR, patients have to face different types of complications, and undergo regular follow-up with intense medical care, to stabilize visual acuity after healing retinitis. Ocular inflammation may occur during the follow-up without significant viral replication. Long-term antiviral therapy is well tolerated and may prevent any further viral relapse.

Keywords: uveitis-clinical/animal model • varicella zoster virus • retinitis 
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