Japanese Journal of Ophthalmology

, Volume 57, Issue 1, pp 98–103 | Cite as

Acute retinal necrosis: factors associated with anatomic and visual outcomes

  • Chiharu Iwahashi-Shima
  • Atsushi Azumi
  • Nobuyuki OhguroEmail author
  • Annabelle A. Okada
  • Toshikatsu Kaburaki
  • Hiroshi Goto
  • Koh-Hei Sonoda
  • Kenichi Namba
  • Nobuhisa Mizuki
  • Manabu Mochizuki
Clinical Investigation



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


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).


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.


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


Acute retinal necrosis Retinal detachment Visual outcome Prophylactic vitrectomy 



The authors thank Hiroshi Keino and Takayo Watanabe (Kyorin University School of Medicine), Kimiko Okinaga (the University of Tokyo), and Norihiko Ito (Yokohama City University) for data collection.


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Copyright information

© Japanese Ophthalmological Society 2012

Authors and Affiliations

  • Chiharu Iwahashi-Shima
    • 1
  • Atsushi Azumi
    • 2
  • Nobuyuki Ohguro
    • 1
    • 11
    Email author
  • Annabelle A. Okada
    • 3
  • Toshikatsu Kaburaki
    • 4
  • Hiroshi Goto
    • 5
  • Koh-Hei Sonoda
    • 6
    • 7
  • Kenichi Namba
    • 8
  • Nobuhisa Mizuki
    • 9
  • Manabu Mochizuki
    • 10
  1. 1.Department of OphthalmologyOsaka University Graduate School of MedicineOsakaJapan
  2. 2.Department of OphthalmologyKobe University School of MedicineKobeJapan
  3. 3.Department of OphthalmologyKyorin University School of MedicineTokyoJapan
  4. 4.Department of OphthalmologyUniversity of Tokyo Graduate School of MedicineTokyoJapan
  5. 5.Department of OphthalmologyTokyo Medical UniversityTokyoJapan
  6. 6.Department of Ophthalmology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  7. 7.Department of OphthalmologyYamaguchi University Graduate School of MedicineYamaguchiJapan
  8. 8.Department of OphthalmologyHokkaido University Graduate School of MedicineSapporoJapan
  9. 9.Department of Ophthalmology and Visual ScienceYokohama City University Graduate School of MedicineYokohamaJapan
  10. 10.Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
  11. 11.Department of OphthalmologyOsaka Koseinenkin HospitalOsakaJapan

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