Retinal Detachment in Patients with Acute Retinal Necrosis: A Case Series

Abstract

Acute retinal necrosis is a rare and severe infectious ocular disease frequently complicated by retinal detachment. Records of six consecutive eyes from five patients with acute retinal necrosis were reviewed. PCR analysis of intraocular fluids was positive for Varizella zoster virus, Herpes virus 1 or 2. Treatment consisted of systemic acyclovir, systemic and local corticosteroids as well as aspirin. Progression of the necrosis could be effectively controlled, however all eyes developed retinal detachment within 55 +/- 24 days. Retinal surgery including pars plana vitrectomy, encircling scleral buckling, liquid silicone or gas filling led to retinal reattachment in all patients during the follow-up time (590 +/- 242 days). The mean visual acuity at the end of the follow-up time was 0.4 +/- 0.3. The diagnosis of acute retinal necrosis is reliably confirmed using PCR analysis of intraocular fluids. Currently available treatments are effective in stopping progression of the necrosis. There is, however, a high risk of retinal detachment, which can be successfully treated with vitreoretinal surgery.