Abstract
Purpose: :
To analyze outcomes of patients with acute retinal necrosis (ARN) and progressive outer retinal necrosis (PORN) and determine what factors are associated with, or predict, long term outcome.
Methods: :
Retrospective chart review of all charts in the Emory system with a diagnosis of posterior uveitis. Outcomes analyzed included visual acuity and presence or absence of retinal detachment. Factors analyzed included diagnosis, quadrants of retina involved, location of involved retina, presence of anterior inflammation, presence of posterior inflammation, disc edema, immune status, and treatment regimen.
Results: :
1258 charts with the diagnosis of posterior uveitis since 1995 were reviewed. Eighty-eight eyes of seventy-five patients carried the diagnosis of PORN or ARN, with sixty-nine of these eyes having complete database entries. Twenty-six eyes of twenty-one patients had complete database entries and one year or longer follow-up. The longest follow-up was one hundred months with the average follow-up being forty months for the twenty-six eyes included in this analysis.At the most recent follow-up six eyes (23%) were 20/40 or better while sixteen eyes (62%) were 20/200 or worse. Two eyes (8%) had documented no light perception (NLP) vision. The detachment rate was 50%. Two of nine eyes (22%) with PORN detached and none progressed to NLP vision. Twelve of seventeen eyes (71%) with ARN detached and two progressed to NLP vision. Four eyes (15%) received prophylactic barricade laser, and 3 (75%) of these eyes detached. Eleven eyes (42%) presented with 20/400 or worse vision, of these eyes only one was better than 20/200 at latest follow-up and seven (64%) were count fingers or worse. Six eyes had four quadrants of retinitis; all had 20/400 or worse vision at latest follow-up.
Keywords: herpes simplex virus • varicella zoster virus