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01-01-2013 | Clinical Investigation

Acute retinal necrosis: factors associated with anatomic and visual outcomes

Authors: Chiharu Iwahashi-Shima, Atsushi Azumi, Nobuyuki Ohguro, Annabelle A. Okada, Toshikatsu Kaburaki, Hiroshi Goto, Koh-Hei Sonoda, Kenichi Namba, Nobuhisa Mizuki, Manabu Mochizuki

Published in: Japanese Journal of Ophthalmology | Issue 1/2013

Abstract

Purpose

To examine the factors associated with anatomic and visual outcomes in Japanese patients with acute retinal necrosis (ARN).

Methods

One hundred four patients with ARN who were followed for more than 1 year at nine referral centers were reviewed. Retinal involvement at initial presentation was classified into four groups: zone 1 (posterior pole, n = 22), zone 2 (midperiphery, n = 54), zone 3 (periphery, n = 25), and unknown (n = 3). Forty-eight eyes underwent prophylactic vitrectomy before development of retinal detachment (vitrectomy group); 56 eyes were treated conventionally without prophylactic vitrectomy (observation group).

Results

The retina was attached in 28 of 48 eyes (58.3 %) in the vitrectomy group and 42 of 56 eyes (75.0 %) in the observation group at the final visit (P = 0.071). At 1 year, 56 eyes (53.8 %) had a best-corrected visual acuity (BCVA) of 20/200 or worse. Multivariate logistic regression analyses identified zone 1 disease (odds ratio = 4.983) and optic nerve involvement (odds ratio = 5.084) as significantly associated with BCVA of 20/200 or worse. Among the zone 3 eyes, significantly (P = 0.012) more eyes in the observation group than in the vitrectomy group had an attached retina.

Conclusions

Prophylactic vitrectomy did not improve the final BCVA in any eyes. Zone 3 eyes had better outcomes without prophylactic vitrectomy.

Urayama A, Yamada N, Sasaki T. Unilateral acute uveitis with retinal periarteritis and detachment [in Japanese]. Jpn J Clin Ophthalmol. 1971;25:607–19.

Holland GN. Executive Committee of the American Uveitis Society. Standard diagnostic criteria for the acute retinal necrosis syndrome. Am J Ophthalmol. 1994;117:663–7.PubMed

Culbertson WW, Blumenkranz MS, Pepose JS, Stewart JA, Curtin VT. Varicella zoster virus is a cause of the acute retinal necrosis syndrome. Ophthalmology. 1986;93:559–69.PubMed

Lewis ML, Culbertson WW, Post JD, Miller D, Kokame GT, Dix RD. Herpes simplex virus type 1. A cause of the acute retinal necrosis syndrome. Ophthalmology. 1989;96:875–8.PubMed

Nishi M, Hanashiro R, Mori S, Masuda K, Mochizuki M, Hondo R. Polymerase chain reaction for the detection of the varicella-zoster genome in ocular samples from patients with acute retinal necrosis. Am J Ophthalmol. 1992;114:603–9.PubMed

de Boer JH, Luyendijk L, Rothova A, Baarsma GS, de Jong PT, Bollemeijer JG, et al. Detection of intraocular antibody production to herpesviruses in acute retinal necrosis syndrome. Am J Ophthalmol. 1994;117:201–10.PubMed

Nussenblatt RB, Whitcup SM. Uveitis: fundamentals and clinical practice. 3rd ed. Philadelphia: Mosby; 2004. p. 201–2.

Muthiah MN, Michaelides M, Child CS, Mitchell SM. Acute retinal necrosis: a national population-based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK. Br J Ophthalmol. 2007;91:1452–5.PubMedCrossRef

Ando F, Kato M, Goto S, Kobayashi K, Ichikawa H, Kamiya T. Platelet function in bilateral acute retinal necrosis. Am J Ophthalmol. 1983;96:27–32.PubMed

10.

Han DP, Lewis H, Williams GA, Mieler WF, Abrams GW, Aaberg TM. Laser photocoagulation in the acute retinal necrosis syndrome. Arch Ophthalmol. 1987;105:1051–4.PubMedCrossRef

11.

Peyman GA, Goldberg MF, Uninsky E, Tessler H, Pulido J, Hendricks R. Vitrectomy and intravitreal antiviral drug therapy in acute retinal necrosis syndrome: report of two cases. Arch Ophthalmol. 1984;102:1618–21.PubMedCrossRef

12.

Min WK, Kang JH. Early surgical management in bilateral acute retinal necrosis. Korean J Ophthalmol. 1990;4:46–9.PubMed

13.

Hillenkamp J, Nölle B, Bruns C, Rautenberg P, Fickenscher H, Roider J. Acute retinal necrosis: clinical features, early vitrectomy, and outcomes. Ophthalmology. 2009;116:1971–5.PubMedCrossRef

14.

Usui Y, Takeuchi M, Goto H, Mori H, Kezuka T, Sakai J, et al. Acute retinal necrosis in Japan. Ophthalmology. 2008;115:1632–3.PubMedCrossRef

15.

Watanabe T, Miki D, Okada AA, Hirakata A. Treatment results for acute retinal necrosis [in Japanese]. Nihon Ganka Gakkai Zasshi. 2011;115:7–12.PubMed

16.

McDonald HR, Lewis H, Kreiger AE, Sidikaro Y, Heckenlively J. Surgical management of retinal detachment associated with the acute retinal necrosis syndrome. Br J Ophthalmol. 1991;75:455–8.PubMedCrossRef

17.

Berker N, Ozdal P, Batman C, Soykan E. Prophylactic vitrectomy in acute retinal necrosis syndrome. Eye. 2006;21:104–6.PubMedCrossRef

18.

Ohguro N, Sonoda KH, Takeuchi M, Matsumura M, Mochizuki M. The 2009 prospective multi-center epidemiologic survey of uveitis in Japan. Jpn J Ophthalmol. 2012;56:432–5.PubMedCrossRef

19.

Holland GN, Buhles WC Jr, Mastre B, Kaplan HJ. A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy. Use of a standardized system for the assessment of disease outcome. Arch Ophthalmol. 1989;107:1759–66.PubMedCrossRef

20.

Johnson LN, Guy ME, Krohel GB, Madsen RW. Levodopa may improve vision loss in recent-onset, nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2000;107:521–6.PubMedCrossRef

21.

Jabs DA, Nussenblatt RB, Rosenbaum JT, Standardization of Uveitis Nomenclature Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol. 2005;140:509–16.PubMedCrossRef

22.

Ishida T, Sugamoto Y, Sugita S, Mochizuki M. Prophylactic vitrectomy for acute retinal necrosis. Jpn J Ophthalmol. 2009;53:486–9.PubMedCrossRef

23.

Sakamoto T, Miyazaki M, Hisatomi T, Nakamura T, Ueno A, Itaya K, et al. Triamcinolone-assisted pars plana vitrectomy improves the surgical procedures and decreases the postoperative blood-ocular barrier breakdown. Graefes Arch Clin Exp Ophthalmol. 2002;240:423–9.PubMedCrossRef

Title: Acute retinal necrosis: factors associated with anatomic and visual outcomes
Authors: Chiharu Iwahashi-Shima
Atsushi Azumi
Nobuyuki Ohguro
Annabelle A. Okada
Toshikatsu Kaburaki
Hiroshi Goto
Koh-Hei Sonoda
Kenichi Namba
Nobuhisa Mizuki
Manabu Mochizuki
Publication date: 01-01-2013
Publisher: Springer Japan
Published in: Japanese Journal of Ophthalmology / Issue 1/2013
Print ISSN: 0021-5155
Electronic ISSN: 1613-2246
DOI: https://doi.org/10.1007/s10384-012-0211-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acute retinal necrosis: factors associated with anatomic and visual outcomes

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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