Acute retinal necrosis: Clinical manifestation and long-term visual outcomes in a series of polymerase chain reaction-positive patients
| Autor: | Maryam Ashraf Khorasani, Ahad Sedaghat, Mirgholamreza Mahbod, Mohammad Zarei, Soheila Asgari, Alireza Hedayatfar, Nazanin Ebrahimiadib |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Herpesvirus 3 Human genetic structures Visual Acuity Clinical manifestation Polymerase Chain Reaction law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law Ophthalmology Medicine Humans Polymerase chain reaction Retrospective Studies business.industry Retinal Detachment Retinal detachment Retinal Retinal Necrosis Syndrome Acute General Medicine medicine.disease eye diseases chemistry Posterior uveitis 030221 ophthalmology & optometry Etiology Acute retinal necrosis business 030217 neurology & neurosurgery |
| Zdroj: | European journal of ophthalmology. 31(4) |
| ISSN: | 1724-6016 |
| Popis: | Purpose: To report the clinical spectrum, viral etiologies, therapeutic interventions, timing of rhegmatogenous retinal detachments (RRD), and visual outcomes in acute retinal necrosis (ARN) syndrome in a series of polymerase chain reaction (PCR)-positive eyes. Methods: From January 2010 to January 2017, consecutive patients with the clinical diagnosis of ARN and a positive aqueous viral PCR were included in this observational, retrospective study. Results: Nineteen eyes found to have a clinical diagnosis of ARN, of which 18 (94.7%) had a positive viral PCR. ARN was unilateral, except in one patient. None of the fellow eyes manifested ARN during follow-up. Varicella-zoster virus (VZV) was detected in 78.0% of ARN eyes. 61.1% of eyes experienced RRD. The median time for the occurrence of RRD was 12 weeks (range: 6–25 weeks) after disease onset. No correlation was found between the etiologic viral agent (VZV vs non-VZV; p = 1.000), extent of retinitis (1–2 quadrant vs 3–4 quadrants; p = 0.326), administration of intravitreal ganciclovir (injected vs not injected; p = 0.332), application of prophylactic laser retinopexy (applied vs not applied; p = 0.326), and subsequent occurrence of RRD. At a 2-year follow-up, visual impairment (VA ⩽ 20/200) and severe visual loss (VA ⩽ light perception) were significantly higher in those complicated by RRD compared to non-RRD eyes (81.8% vs 28.6%; p = 0.047, and 45.4% vs 0.0%; p = 0.004, respectively). Conclusion: Aqueous PCR results are highly consistent with the clinical diagnosis of ARN. Regardless of the method of management, the rate of RRD is high and is associated with a poor visual outcome. |
| Databáze: | OpenAIRE |
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