Acute Retinal Necrosis: Diagnosis, Management, Complications and Outcomes of an 8 Year Retrospective Case Series

Title: Acute Retinal Necrosis: Diagnosis, Management, Complications and Outcomes of an 8 Year Retrospective Case Series.

Background: The purpose of the study was to describe demographics, characteristics and management of eyes with acute retinal necrosis (ARN).

Methods: Retrospective chart review of patients with ARN that presented to University Hospital (UH), New Jersey Medical School between January 2005 and December 2012.

Findings: Fourteen patients presented with a clinical diagnosis of acute retinal necrosis. Seven of 14 patients (50%) had bilateral involvement on presentation. Vision on presentation in the affected eye ranged from 20/40 to no light perception; the majority of patients had 20/400 vision or worse. All patients were admitted for intravenous antiviral treatment. All eyes received intravitreal ganciclovir injection (2.0 mg/0.1 cc) +/- foscarnet injection (2.4 mg/0.1 cc). Some eyes underwent multiple intravitreal treatments or ganciclovir implant placement. Thirteen eyes (62%) required rhegmatogenous retinal detachment repair.

Conclusion: We reviewed 21 eyes of 14 patients with acute retinal necrosis. Only 29% of eyes had final BCVA better than 20/200, in concert with previous reports on the high degree of ocular morbidity associated with acute retinal necrosis. Review of the literature regarding immune status and acute retinal necrosis lends insight into the evolving concepts on this clinical entity.

Author(s): Shriji N Patel, Lekha K Mukkamala, Ronald J Rescigno, Marco A Zarbin, Paul D Langer and Neelakshi Bhagat

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