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Acute retinal necrosis: clinical features, management and outcomes



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


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


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).


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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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).

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