Acute retinal necrosis: clinical features, management and outcomes--a 10 year consecutive case series

Abstract

Purpose: To determine the viral diagnosis and clinical outcome of eyes with acute retinal necrosis (ARN).

Method: A retrospective analysis was done of 62 eyes of 53 patients presenting to a tertiary care ophthalmic institute between 1997 and 2007 with features of ARN. All patients with active disease were started immediately on intravenous acyclovir followed by oral antivirals along with systemic steroids. A prophylactic laser retinopexy was performed in patients with a clear media to areas posterior to the necrotic retina.

Results: The aqueous and the vitreous sample revealed herpes simplex virus in 19 (30.60%) and varicella zoster virus in 28 patients (45.16%). Forty-one (66.12%) eyes had retinal detachment. Prophylactic laser photocoagulation was given in 19 (30.64%) eyes. Surgical intervention was required in 32 (51.61%) eyes. Favorable functional outcome was seen in 28 (45.1%) eyes.

Conclusion: ARN is a fulminant disorder, which if treated early and aggressively gives good results.

Keywords: Acute; India; clinical features; management; outcome; retinal necrosis.