JUN 30, 2010
By Nancy Eve Thomas, MD
Comprehensive Ophthalmology
The authors conducted this retrospective study to determine the long-term visual acuity outcomes of acute retinal necrosis patients based on retinitis severity and treatment modality. The authors found that most patients with moderate disease who received intravitreal treatment experienced stable or improved visual acuity. However, intravitreal treatment did not prevent visual acuity loss in patients with severe disease.
They reviewed the medical records of patients clinically diagnosed with acute retinal necrosis over a 10-year period at a university uveitis service. Twenty patients (25 eyes) with at least one follow-up visit were included in their analysis.
Eleven eyes received intravitreal injections of ganciclovir and/or foscarnet. Fourteen patients were treated with intravenous antiviral medications and 19 with oral antivirals. Mean visual acuity at all time points was best when retinitis involved less than 25 percent of the retina and decreased as the involved area increased. Five of the six eyes with greater than 50 percent retinal involvement experienced decreased vision regardless of treatment. Three of the four eyes with 25 to 50 percent involvement that received intravitreal antivirals experienced improved visual acuity of two or more Snellen lines. Five of the total group of 25 eyes developed retinal detachment, although none of the six eyes treated with prophylactic laser detached.
The authors conclude that retinitis affecting a greater retinal area portends a worse visual prognosis.