Original ArticleAcute Retinal Necrosis: Features, Management, and Outcomes
Section snippets
Materials and Methods
Clinical diagnosis of ARN was based on the presence of (1) acute panuveitis, (2) occlusive retinal vasculitis (arteritis and phlebitis) with or without retinal hemorrhage, and (3) peripheral patchy necrotizing retinitis (usually multifocal) with or without retinal breaks and optic disc swelling. Other symptoms and signs when present are supportive of diagnosis: ocular or periocular pain, conjunctivitis, episcleritis, scleritis, rapid circumferential spreading and coalescence of the necrotizing
Results
There were 22 patients (12 female, 10 male). Of patients, 22.7% (5/22) had bilateral ARN; 9.1% (2/22) presented with bilateral disease at first presentation, and 13.6% (3/22) developed ARN in the fellow eye on day 14 (day 9 on acyclovir treatment), day 53 (day 53 on acyclovir treatment), and day 166 (day 110 after 56 days on acyclovir treatment), respectively, after first-eye presentation. Median age at disease onset was 51 years (49.5±3.5; range, 18–83). Mean follow-up was 4 years (range,
Discussion
Our results show that (1) VZV is the leading cause of ARN, followed by HSV (types 1 and 2); (2) all the EBV-positive eyes were also positive for VZV; (3) systemic corticosteroid treatment given before the diagnosis of ARN did not appear to correlate with the subsequent development of RD; (4) prophylactic argon laser treatment significantly reduced the risk of developing RD; (5) RD usually occurred after the third week after onset of symptoms, but there were late occurrences up to 5 months
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Manuscript no. 2005-869.