J Korean Ophthalmol Soc.  2013 Nov;54(11):1694-1699. 10.3341/jkos.2013.54.11.1694.

Risk Factors of Retinal Detachment after Acute Retinal Necrosis

• Park SW
• Shin MK
• Byon IS
• Park HJ
• Lee JE
• Oum BS

• KMID: 2217916
• DOI: http://doi.org/10.3341/jkos.2013.54.11.1694

Abstract

PURPOSE
Retinal detachment (RD) complicated in acute retinal necrosis (ARN) is difficult to be treated and a main cause of blindness. The factors associated with RD in ARN were investigated.
METHODS
Patients with ARN who were diagnosed and treated from Jan, 2008 to Dec, 2012 were reviewed retrospectively. The eyes were classified into the group I without RD, and the group II with RD. Early vitrectomy, history of ARN in the other eye, extent of necrosis, symptom duration and intravitreal injection of anti-viral drug were evaluated.
RESULTS
Of 22 eyes of 20 patients, 11 eyes were included in each group. Symptom duration of 8.0 days in the group I was shorter than 15.8 days in the group II (p = 0.005). There were no macular involvement at initial exam in the group I and 5 eyes (45%) in the group II (p = 0.017). Five eyes (45%) in the group I and 0 eye (0%) in the group II had history of ARN in the other eye (p = 0.017). Six eyes (55%) in the group I and 1 eye (9%) in the group II underwent early vitrectomy (p = 0.031). Age, baseline visual acuity, and intravitreal injection of antiviral agent were not related to RD (p = 0.294-0.699).
CONCLUSIONS
Broader necrosis and longer symptoms duration were related to occurrence of RD. Correlation of Lower risk of RD with ARN history in the other eye would result from earlier diagnosis and treatment. Early vitrectomy seems to be effective to prevent RD in ARN.

Keyword

Acute retinal necrosis; Early vitrectomy; Retinal detachment

MeSH Terms

Blindness
Diagnosis
History
Humans
Intravitreal Injections
Necrosis
Retinal Detachment*
Retinal Necrosis Syndrome, Acute*
Retinaldehyde*
Retrospective Studies
Risk Factors*
Visual Acuity
Vitrectomy
Retinaldehyde

Figure

• 

  Figure 1. Group I, patient 5. (A) Two days after systemic antiviral and laser treatment, fundus photo shows that retinal necrosis did not extend to the macula. Pigmented laser scar (black arrow) by previous treatment several years ago is noted. (B) Five months after early vitrectomy, there is no retinal detachment, vitreous inflammation, or retinal necrosis.

• 

  Figure 2. Group II, patient 12. (A) Two days after systemic antiviral and laser treatment, fundus photo shows that the macula was involved by retinal necrosis. (B) Ten days after early vitrectomy, vitreous cavity was filled with silicone oil and the retina is attached without necrotic lesion. (C) Fifty days after early vitrectomy, although it is filled with the tamponade, subretinal fluid is note. (D) Optical coherence tomography demonstrates presence of subretinal fluid.

Reference

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