A survey of Initial electroretinogram (ERG) examination for Acute Retinal Necrosis (ARN) in multi-center study

Abstract

Purpose : Acute retinal necrosis (ARN) is a severe retinal condition, predominantly caused by Varicella-zoster virus (VZV) and herpes simplex virus (HSV). It poses a significant threat to vision, often presenting with panuveitis, retinal vasculitis, and retinal necrosis, leading to severe visual impairment or blindness. Despite well-documented clinical symptoms, the alterations in retinal electrophysiological function during ARN progression are not extensively studied.

Methods : This retrospective observational study enrolled 70 participants (31 females, 39 males). The group included 17 cases of clinically diagnosed ARN, 8 of bacterial endophthalmitis, 15 of other infectious uveitis (including cases of CMV retinitis, fungal endophthalmitis, HTLV-1, VZV associated iritis, toxoplasmosis), and 23 of non-infectious uveitis. Full-field electroretinography (ERG) was utilized to assess retinal electrophysiological function at the initial examination. Visual acuity was recorded initially and post-treatment. A wave amplitude was measured and analyzed across groups, with statistical comparisons made between cases.

Results : The study revealed a significant reduction in A wave amplitude in the retinal electrophysiological function from the initial stages of ARN and bacterial endophthalmitis. Initial visual acuity was notably poor in cases of ARN and bacterial infection, while it was comparatively better in patients with other infectious uveitis than those with non-infectious uveitis. Post-treatment visual acuity remained poor in ARN and bacterial infection cases.

Conclusions : The research provides comprehensive insights into the temporal changes in retinal electrophysiological function during the progression of acute retinal necrosis. The early and notable reduction in ERG responses highlights the urgent need for prompt diagnosis and effective therapeutic interventions to mitigate visual impairment in ARN patients. Further investigations are encouraged to explore potential therapeutic strategies to preserve retinal function and prevent irreversible visual loss in this complex ocular condition.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.