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. 2025 Jul 1;15(1):51.
doi: 10.1186/s12348-025-00511-8.

Clinical findings, outcomes following management and complications of acute retinal necrosis: the experience of a tertiary eye centre in Saudi Arabia

Enas Magharbil  1   2 , Faisal Al-Qahtani  1 , Maram Al-Enazi  1 , Abdulrahman H Badawi  1 , Nora Alyousif  1 , Moustafa S Magliyah  3 , Hassan Al-Dhibi  1   4
Affiliations

Clinical findings, outcomes following management and complications of acute retinal necrosis: the experience of a tertiary eye centre in Saudi Arabia

Enas Magharbil et al. J Ophthalmic Inflamm Infect. .

Abstract

Purpose: To study the clinical picture, outcomes and the complications of acute retinal necrosis (ARN) in a tertiary eye hospital.

Methods: This is retrospective chart review of all patients who were diagnosed with ARN and were treated and followed up at King Khaled Eye Specialist Hospital (KKESH). Details of clinical examinations, Polymerase Chain Reaction (PCR) results, systemic and topical treatments, complications and managements of complications were obtained.

Results: Twenty eight eyes of 26 patients were included. The results of PCR were positive in 22 eyes. Systemic antiviral therapy with intravenous Acyclovir 10 mg/Kg three times daily was given to all cases. Eight patients were treated with intravitreal ganciclovir injections. Fifteen eyes (56.3%) had rhegmatogenous retinal detachment (RRD) and 11 of them had surgical interventions. The risk of developing RRD was significantly high in severe vitritis (P = 0.007, OR = 3.825), diffuse or multifocal retinitis (P = 0.010, OR = 1.04) and the larger extent of retinitis (P = 0.016). The final visual outcome was worse among eyes which developed RRD (LogMAR 1.6 ± 0.94, Snellen = 20/800) than eyes which did not develop RRD (LogMAR 0.81 ± 0.84, Snellen = 20/125) and the difference was statistically significant (P = 0.031).

Conclusion: The visual outcomes of ARN are significantly worse in eyes which develop RRD. More severe and larger extent of posterior segment involvement confer higher risks of RRD development in ARN.

Keywords: ARN; Acute retinal necrosis; Panuveitis; Pars plana vitrectomy; Retinal detachment; Scleral bucking; Viral retinitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study adhered to the tenets of the declaration of Helsinki at 1964 and its amendments. The study was approved by the Institutional review board (IRB) at King Khaled Eye Specialist Hospital (KKESH), IRB number: RP 22013-R. Informed consents were obtained from all participants included in this study. Consent for publication: Informed consents were obtained from all participants to publish the study material. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan Meier survival curve of the probability of acute retinal necrosis (ARN) eyes not developing RRD over time
Fig. 2
Fig. 2
Kaplan Meier survival curve of eyes being free of recurrent RRD after primary repair
See this image and copyright information in PMC

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