Acute retinal necrosis: factors associated with anatomic and visual outcomes.

Abstract

PURPOSE:

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

METHODS:

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).

RESULTS:

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.

CONCLUSIONS:

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

• Authors: Chiharu Iwahashi-Shima, Atsushi Azumi, Nobuyuki Ohguro, Annabelle A Okada, Toshikatsu Kaburaki, Hiroshi Goto, Koh-Hei Sonoda, Kenichi Namba, Nobuhisa Mizuki, Manabu Mochizuki
• Journal: Japanese journal of ophthalmology (Jpn J Ophthalmol) Vol. 57 Issue 1 Pg. 98-103 (Jan 2013) ISSN: 1613-2246 [Electronic] Japan
• PMID: 23117419 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Aged
• Child
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Retina (pathology)
• Retinal Detachment (etiology, physiopathology, prevention & control)
• Retinal Necrosis Syndrome, Acute (complications, physiopathology, surgery)
• Retrospective Studies
• Treatment Outcome
• Visual Acuity
• Vitrectomy
• Young Adult