Abstract
Abstract: :
Purpose: Acute retinal necrosis (ARN) is known to be a rapidly progressive form of uveoretinitis. Although histopathological examination is essential to understand the pathogenesis of this disease, acute phase samples are not easily available. To analyse the retinal findings of retina in patients with ARN, optical coherence tomography (OCT) was performed. Methods: Eight patients (8 eyes) with ARN were studied using OCT. The diagnosis of ARN was based on characteristic ocular manifestations and detection of viral DNA in intraocular fluid by polymerase chain reaction. Results: Corresponding to yellowish white lesions of the retina in acute phase, OCT images depicted highly reflective areas in the inner layers of the retina in all 8 cases, similar to the findings observed in patients with central retinal artery occlusion (CRAO). Disorganization of the retinal structure was also observed in these retinal lesions, especially in severe cases. Subretinal changes including retinal exudate and/or fluid were observed in only one case. After the yellowish white lesions in the retina regressed, significant reduction of retinal thickness was observed by OCT. Partial posterior vitreous detachment, which could not be recognized by ophthalmoscopic examination was also detected by OCT. Conclusions: Yellowish white lesions of the retina in ARN probably reflect the ischemic changes caused by obstructive retinal vasculitis and direct viral cytopathic effects rather than the accumulation of inflammatory products. OCT permits detection of abnormal retinal structures in patients in the acute phase of ARN and these clinical findings may be useful at the time of subsequent vitrectomy.
Keywords: uveitis–clinical/animal model • retinochoroiditis • pathology: human