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Acute retinal necrosis: clinical features, management and outcomes

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Abstract

Purpose

To evaluate the clinical features, treatment, and visual outcome of patients with acute retinal necrosis (ARN).

Methods

The data of patients were retrospectively reviewed. Factors associated with visual loss and factors affecting the risk for retinal detachment (RD) development were evaluated.

Results

Twenty-four eyes of 24 patients (7 female/17 male, mean age 43.7 years, mean follow-up period 31.0 months) were included. In ocular fluid samples of 15 (83%) out of 18 eyes, polymerase chain reaction (PCR) tests were positive for herpes simplex virus (seven eyes; 39%), varicella zoster virus (six eyes; 33%), cytomegalovirus (one eye; 6%), and adenovirus (one eye; 6%). Central retinal occlusive vasculitis was observed in three (13%) eyes. Systemic antiviral therapy was given to all patients, and additional intravitreal ganciclovir was administered in seven eyes (29%). The most common complication was RD (46%). There was no statistically significant difference in the frequency of RD between herpes simplex virus- and varicella zoster virus-positive patients (p = .617). The rate of RD was similar in eyes undergoing prophylactic laser photocoagulation (LPC), eyes undergoing vitrectomy + LPC, and eyes not undergoing LPC (p = .237). The number of eyes with final visual acuity below 20/200 was significantly higher in eyes with RD than without RD (p = .047).

Conclusion

Prophylactic LPC and vitrectomy did not show clear benefits in terms of preventing RD development. RD was the most common complication and a major factor for a poor visual prognosis.

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Acknowledgements

The authors declare that they have no competing interests

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The authors have indicated they have no financial relationships with any company and no external funding.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ulucanlar Street, Number: 59, 06250, Ankara, Turkey

    Kubra Ozdemir Yalcinsoy, Pinar Cakar Ozdal, Merve Inanc Tekin & Yasemin Ozdamar Erol

  2. Department of Ophthalmology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey

    Mustafa Salih Karatepe

Authors
  1. Kubra Ozdemir Yalcinsoy
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  2. Pinar Cakar Ozdal
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  3. Merve Inanc Tekin
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  4. Mustafa Salih Karatepe
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  5. Yasemin Ozdamar Erol
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Contributions

All authors have read and agreed to the published version of the manuscript. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [KOY] and [PCO], [YOE], [MSK], [MIT]. The first draft of the manuscript was written by [KOY], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kubra Ozdemir Yalcinsoy.

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The study was designed following the Helsinki Declaration principles and was approved by the Ankara Training and Research Hospital’s Ethics Committee.

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Ozdemir Yalcinsoy, K., Cakar Ozdal, P., Inanc Tekin, M. et al. Acute retinal necrosis: clinical features, management and outcomes. Int Ophthalmol 43, 1987–1994 (2023). https://doi.org/10.1007/s10792-022-02598-7

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  • DOI: https://doi.org/10.1007/s10792-022-02598-7

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