Visual outcome and poor prognostic factors in acute retinal necrosis syndrome.

Abstract

To evaluate the impact of selected clinical parameters on the mid-/long-term visual outcome of patients with acute retinal necrosis (ARN) A retrospective cohort study Two University Hospitals (Parma, Italy; Lausanne, Switzerland). Thirty-nine non-HIV patients (39 eyes) with ARN, as confirmed by polymerase chain reaction on intraocular samples. The following potential predictors were tested using linear regression models: age, sex, etiology, best-corrected visual acuity (BCVA) on admission, delay between ARN symptom onset and treatment initiation, and surgery (performed or not). BCVA at the final follow up Thirty-nine of 39 non-HIV patients (22 men and 17 women; mean age, 50years) diagnosed with ARN were enrolled in the study. Etiologies were: varicella-zoster virus in 25 eyes (64%), herpes simplex viruses in the remaining 14 eyes. The average follow-up duration was 19 ± 13months. All patients had undergone systemic antivirals; surgery was performed in 16 eyes. The mean delay between onset of visual symptoms and antiviral treatment initiation was 15 ± 31days (range, 1-180days). The mean BCVA at baseline was 0.83 ± 0.75logMAR, while the mean final BCVA was 0.75 ± 0.81logMAR. Both initial BCVA and treatment delay (TD) were significantly correlated with the final BCVA (p< 0.05). Initial BCVA and TD seem to be significant predictors of mid-/long-term visual outcome in non-HIV patients affected by ARN.