Acute Retinal Necrosis: Experience in a Reference Center in Santander - Colombia

Ocul Immunol Inflamm. 2023 Aug 15:1-9. doi: 10.1080/09273948.2023.2244076. Online ahead of print.

Abstract

Introduction: Acute retinal necrosis (ARN) is a severe eye disease demanding swift treatment to prevent blindness. Early action involving antiviral medications and corticosteroids is crucial for optimal visual outcomes.

Objective: We present an ARN case series showcasing treatment experience and results.

Methodology: Patients diagnosed with ARN based on SUN Working Group 2021 criteria were included; all underwent comprehensive eye exams, PCR analysis, and imaging.

Results: Eight patients were studied; PCR confirmed ARN in six. Induction treatment, either oral valacyclovir (5/8) or intravenous acyclovir (3/8), lasted 10-14 days. Maintenance included oral valacyclovir (6/8), oral valganciclovir (2/8) for six months, along with intravitreal ganciclovir. Visual outcomes were similar for oral and intravenous therapies; poor baseline acuity and macular involvement tend to result in a worse final acuity.

Conclusions: Swift treatment is vital to ARN management. Our findings emphasize effective treatment strategies' role in visual prognosis.

Abbreviations: ACV: Acyclovir; BCVA: Best Corrected Visual Acuity; CMV: Cytomegalovirus; EBV: Epstein Barr Virus; FTA-ABS: Fluorescent treponemal antibody absorption test; HSV 1-2: Herpes simplex virus 1-2; HIV: Human Immunodeficiency Virus; IV-ACV: Intravenous- Acyclovir; PCR: Polymerase Chain Reaction;Tg: Toxoplasma gondii; VZV: Varicella Zoster Virus; VCV: Valacyclovir; VDRL: Venereal disease research laboratory test.

Keywords: Acute retinal necrosis; Herpes simplex; intravenous acyclovir; oral valacyclovir; retina.