Pattern of Acute Retinal Necrosis in a Referral Center in Tunisia, North Africa

Khochtali, Sana; Abroug, Nesrine; Kahloun, Rim; Ksiaa, Imen; Nahdi, Imen; Zaouali, Sonia; Yahia, Salim Ben; Khairallah, Moncef

doi:10.3109/09273948.2014.925125

Cited by 11 publications

(13 citation statements)

References 28 publications

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“…The poor prognosis of the disease was clearly demonstrated, with 40% of eyes having severe vision loss at final follow-up, an incidence marginally lower than that reported in similar studies (48%-75%). 3,5,6,13,14,34 RD during the clinical course was common, occurring in 46% of eyes, an incidence rate consistent with other series. Despite antiviral treatments, bilateral involvement occurred in 8% of our cohort, marginally lower than the 14%-17% reported elsewhere.…”

Section: Discussionsupporting

confidence: 87%

“…The present study found that more posteriorly involved zones of retinitis portend a poorer visual outcome (P < .001), a relationship supported in the literature. 14,17,24 Also of note was the strong association between the total area of retinitis and final VA. Similar to other reports, 7,14,15,17 retinitis involving <25% of the retina was associated with a good visual outcome, whereas !50% portended severe vision loss.…”

Section: Prognostic Indicatorsmentioning

confidence: 98%

“…3,7,11 Despite diagnostic and treatment advances, profound vision loss is still common, with 48%-76% of eyes having final visual acuity (VA) !1.00 log of the minimum angle of resolution (logMAR) (Snellen equivalent, <20/200). 3,5,6,8,13,14 Optic nerve involvement 5,[15][16][17] and RD 11,18,19 are significant determinants of visual outcome. Review of 565 eyes across 13 studies in the literature reveals the overall incidence of RD is 51%.…”

Section: Introductionmentioning

confidence: 99%

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Acute Retinal Necrosis Multicenter Case Series: Prognostic Indicators and Treatment Outcomes

Dorman

Donaldson

2018

Journal of VitreoRetinal Diseases

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The purpose of this article is to report the prognostic associations of acute retinal necrosis (ARN), determine the diagnostic utility of aqueous vs vitreous polymerase chain reaction (PCR), and describe outcomes of antiviral, corticosteroid, antithrombotic, and laser retinopexy treatment. Methods: A retrospective, nonrandomized case series was conducted. Primary outcomes included final visual acuity (VA), severe VA loss (!1.00 log of the minimum angle of resolution [logMAR] [Snellen equivalent, <20/200]), and retinal detachment (RD). Results: Fifty eyes of 46 patients were diagnosed with ARN. Varicella-zoster and herpes simplex viruses were the viral etiology in 29 and 16 eyes, respectively. Five were diagnosed on clinical criteria. Intravenous acyclovir was administered in 90% of eyes. Neither induction therapy for !13 days (P ¼ .692) nor intravitreal medication (P ¼ .203) decreased the incidence of severe vision loss. Maintenance antiviral medication was administered in 96% of eyes (50% received >13 weeks). At final follow-up, 40% of eyes had severe vision loss (range,-0.08 to þ3.0 logMAR [Snellen, 20/17-no perception of light]). Forty-six percent developed RD. Relative afferent pupillary defect (RAPD), zone and extent of retinitis, and RD were prognostic of final VA. Antithrombotic therapy was administered in 25/50 eyes and was associated with lower incidence of severe VA loss (P ¼ .027) and better final VA (P ¼ .040). Laser retinopexy was performed in 40% of eyes with no significant effect on RD incidence (P ¼ .901) or severe VA loss (P ¼ .451). Conclusions: ARN has a high incidence of RD and poor visual outcomes. Aqueous humor PCR is the first-line diagnostic investigation. Prognostic indicators include RD, RAPD, zone, and extent of retinitis. Induction antiviral medication is appropriate for at least 12 days. Antithrombotic medication is associated with improved outcomes. Laser retinopexy does not reduce the incidence of RD.

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Section: Discussionsupporting

confidence: 87%

Section: Prognostic Indicatorsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Acute Retinal Necrosis Multicenter Case Series: Prognostic Indicators and Treatment Outcomes

Dorman

Donaldson

2018

Journal of VitreoRetinal Diseases

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“…107 Secondary retinal detachment is a known possible complication of ARN. 108 ARN has an increased prevalence in men with 56-72% of ARN patients being male. 77, 107-109 Further, ARN severity is correlated with gender; in one study of 22 individuals with ARN, male gender was a risk factor for severe vision loss at 6 and 12 months (p = 0.019 and p = 0.008 respectively).…”

Section: Infectious Uveitidesmentioning

confidence: 99%

The Role of Sex in Uveitis and Ocular Inflammation

Yeung¹,

Popp²,

Chan³

2015

International Ophthalmology Clinics

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Uveitides can be due to non-infectious and infectious etiologies. It has been observed that there is a gender difference with a greater preponderance of non-infectious uveitis in women than in men. This review will describe both non-infectious and infectious uveitides and describes some of the current autoimmune mechanisms thought to be underlying the gender difference. It will specifically look at non-infectious uveitides with systemic involvement including juvenile idiopathic arthritis, spondyloarthopathies, sarcoidosis, Behçet’s disease, and Vogt-Koyanagi-Harada disease and at uveitides without systemic involvement including sympathetic ophthalmia, birdshot chorioretinitis, and the white dot syndromes. Infectious uveitides like acute retinal necrosis, progressive outer retinal necrosis, and cytomegalovirus mediated uveitis will be mentioned. Different uveitides with female- or male- predominance are presented and discussed.

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“…1 , 2 , 3 , 4 Herpes virus family members herpes simplex virus (HSV), varicella zoster virus (VZV), Epstein-Barr virus, and cytomegalovirus play a role in its etiology. 2 , 3 , 4 , 5 , 6 The most common agent is reported as VZV in some studies and HSV-1 in others. 5 Ganatra et al 6 reported that VSV and HSV-1 were more common in patients over 25 years old, while HSV-2 was more common in those under 25 years old.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Oral Valacyclovir Treatment in a Case with Acute Retinal Necrosis

Şimşek¹,

Özdal²,

Tekin³

2017

tjo

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Acute retinal necrosis (ARN) is a rapidly progressive disease with poor prognosis, leading to visual loss in most cases. Rapid diagnosis and early anti-viral treatment significantly affect the course and prognosis of the disease. In this case report, we present a 34-year-old female patient referred to our clinic with symptoms of blurred vision and ocular pain diagnosed as acute glaucoma elsewhere. A clinical diagnosis of ARN was made and anti-viral treatment was started immediately. We herein describe our treatment approach to this particular case and discuss previously reported treatment modalities.

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Pattern of Acute Retinal Necrosis in a Referral Center in Tunisia, North Africa

Abstract: ARN carries poor visual prognosis in Tunisia.

Cited by 11 publications

References 28 publications

Acute Retinal Necrosis Multicenter Case Series: Prognostic Indicators and Treatment Outcomes

Acute Retinal Necrosis Multicenter Case Series: Prognostic Indicators and Treatment Outcomes

The Role of Sex in Uveitis and Ocular Inflammation

Efficacy of Oral Valacyclovir Treatment in a Case with Acute Retinal Necrosis

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