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Observational Study
. 2021 Oct;259(10):2905-2911.
doi: 10.1007/s00417-021-05166-4. Epub 2021 Apr 12.

Association of retinal detachment with age 50 years or younger at onset in patients with acute retinal necrosis

Cristhian A Urzua  1   2   3   4 , Jared Knickelbein  5 , Loreto Cuitino  6   7 , Uriel Moreno  8 , Rodrigo Anguita  9 , Victor Velasquez  10 , Luz Elena Concha-Del-Rio  8 , Sergio Morales  10 , Francisco A Villarroel  10 , H Nida Sen  5 , Lourdes Arellanes-Garcia  8
Affiliations
Observational Study

Association of retinal detachment with age 50 years or younger at onset in patients with acute retinal necrosis

Cristhian A Urzua et al. Graefes Arch Clin Exp Ophthalmol. 2021 Oct.

Abstract

Background: Due to the guarded prognosis of acute retinal necrosis (ARN), it is relevant to develop a strategy to early categorize those patients in a higher risk of worse outcomes. The purpose of this study is to describe clinical features and predictive factors for retinal detachment (RD) in patients with ARN.

Methods: Retrospective observational case series of 34 adult patients (38 eyes) with ARN examined between January 2005 and July 2015 in the National Eye Institute (Bethesda, USA), the Department of Ophthalmology, University of Chile (Santiago, Chile), and APEC (CDMX, Mexico).

Results: A total of 16 males and 18 females with a mean age at presentation of 44.5 ± 16.8 years were included. Twenty-seven patients (79.4%) received intravenous acyclovir as first-line treatment, and 7 patients received either oral antiviral (4 patients) or oral plus intravitreal antiviral (3 patients). All subjects were treated with prednisone, with a mean initial dose of 57.7 ± 16.3 mg per day. Seventeen patients (50.0%) developed retinal detachment. An association of retinal detachment with age at onset was observed (p = 0.04), with patients younger than 50 years presenting a higher risk (OR = 14.86, p = 0.0009). Additionally, patients in this higher risk group had more inflammation in both anterior chamber and vitreous (p = 0.04 and 0.03, respectively). No other predictive factor for retinal detachment was found in the present study.

Conclusions: RD represents an important complication in patients with ARN. Younger patients may be at higher risk of this complication, possibly secondary to the presence of a higher level of inflammation.

Keywords: Acute retinal necrosis; Predictive factors; Retinal detachment; Younger age.

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