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Association of retinal detachment with age 50 years or younger at onset in patients with acute retinal necrosis

  • Retinal Disorders
  • Published:
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Abstract

Background

Due to the guarded prognosis of acute retinal necrosis (ARN), it is relevant to develop a strategy to early categorize those patients in a higher risk of worse outcomes. The purpose of this study is to describe clinical features and predictive factors for retinal detachment (RD) in patients with ARN.

Methods

Retrospective observational case series of 34 adult patients (38 eyes) with ARN examined between January 2005 and July 2015 in the National Eye Institute (Bethesda, USA), the Department of Ophthalmology, University of Chile (Santiago, Chile), and APEC (CDMX, Mexico).

Results

A total of 16 males and 18 females with a mean age at presentation of 44.5 ± 16.8 years were included. Twenty-seven patients (79.4%) received intravenous acyclovir as first-line treatment, and 7 patients received either oral antiviral (4 patients) or oral plus intravitreal antiviral (3 patients). All subjects were treated with prednisone, with a mean initial dose of 57.7 ± 16.3 mg per day. Seventeen patients (50.0%) developed retinal detachment. An association of retinal detachment with age at onset was observed (p = 0.04), with patients younger than 50 years presenting a higher risk (OR = 14.86, p = 0.0009). Additionally, patients in this higher risk group had more inflammation in both anterior chamber and vitreous (p = 0.04 and 0.03, respectively). No other predictive factor for retinal detachment was found in the present study.

Conclusions

RD represents an important complication in patients with ARN. Younger patients may be at higher risk of this complication, possibly secondary to the presence of a higher level of inflammation.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

ARN:

Acute retinal necrosis

RD:

Retinal detachment

VZV:

Varicella zoster Virus

NEI:

National Eye Institute

APEC:

Asociacion para Evitar la Ceguera

BCVA:

Best-corrected visual acuity

ROC:

Receiver operating characteristic curve

HSV:

Herpes simplex Virus

PVD:

Posterior vitreous detachment

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Authors and Affiliations

  1. Department, of Ophthalmology, Faculty of Medicine, University of Chile, Independencia 1027, Independencia, Santiago, Chile

    Cristhian A. Urzua & Rodrigo Anguita

  2. Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD, USA

    Cristhian A. Urzua, Jared Knickelbein & H. Nida Sen

  3. Laboratory of Autoimmune Ocular and Systemic Diseases, University of Chile, Santiago, Chile

    Cristhian A. Urzua & Loreto Cuitino

  4. Clinica Alemana-Universidad del Desarrollo, Santiago, Chile

    Cristhian A. Urzua

  5. Servicio de Oftalmología, Hospital Clínico Universidad de Chile, Santiago, Chile

    Loreto Cuitino

  6. Inflammatory Eye Disease Clinic, Dr. Luis Sanchez Bulnes” Hospital, Asociación para Evitar la Ceguera en México (APEC), Mexico City, CDMX, Mexico

    Uriel Moreno, Luz Elena Concha-del-Rio & Lourdes Arellanes-Garcia

  7. Hospital Del Salvador, Facultad de Medicina, Universidad de Chile, Santiago, Chile

    Victor Velasquez, Sergio Morales & Francisco A. Villarroel

Authors
  1. Cristhian A. Urzua
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  2. Jared Knickelbein
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  3. Loreto Cuitino
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  4. Uriel Moreno
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  5. Rodrigo Anguita
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  6. Victor Velasquez
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  7. Luz Elena Concha-del-Rio
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  8. Sergio Morales
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  9. Francisco A. Villarroel
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  10. H. Nida Sen
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  11. Lourdes Arellanes-Garcia
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Contributions

Conception and design: CAU, JK. Data collection: CAU, JK, UM-P, RA. Analysis and interpretation: all authors. Drafting the work and revising it critically for important intellectual content: all authors. Final approval of the version to be published: all authors.

Corresponding author

Correspondence to Cristhian A. Urzua.

Ethics declarations

Ethics approval and consent to participate

All patients were seen under an Institutional Review Board–approved protocol at their respective clinics and the Ethics Committee of the University of Chile approved the study (ID: 0062019). The protocol fulfilled the tenets of the Declaration of Helsinki.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Urzua, C.A., Knickelbein, J., Cuitino, L. et al. Association of retinal detachment with age 50 years or younger at onset in patients with acute retinal necrosis. Graefes Arch Clin Exp Ophthalmol 259, 2905–2911 (2021). https://doi.org/10.1007/s00417-021-05166-4

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  • DOI: https://doi.org/10.1007/s00417-021-05166-4

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