BILATERAL ACUTE RETINAL NECROSIS: A Case Series

Purpose:To investigate the clinical characteristics and visual outcome of bilateral acute retinal necrosis.Methods:The study included 30 patients (60 eyes) who were diagnosed with bilateral acute retinal necrosis. The medical records were reviewed.Results:Twenty-five patients developed the disease in the contralateral eye within 5 months and 5 patients at >2 years after the initial onset. At presentation, 14 of 21 eyes suffered from retinal necrosis of more than 180 degrees in the initially affected eye, whereas 3 of 22 eyes suffered it in the later-affected eye. Retinal detachment occurred in 23 of the 27 initially affected eyes and in 5 of the 27 later-affected eyes. The mean logarithm of the minimum angle of resolution best-corrected visual acuity decreased from 2.0 1.1 (Snellen equivalent counting fingers) to 2.2 +/- 1.0 (Snellen equivalent counting fingers) in the initially affected eyes after a follow-up of 34.1 +/- 48.2 months (P = 0.529), and improved from 0.5 +/- 0.4 (Snellen equivalent 20/66) to 0.3 +/- 0.4 (Snellen equivalent 20/40) in the later-affected eyes after a follow-up of 21.2 +/- 23.3 months (P = 0.005).Conclusion:Bilateral acute retinal necrosis usually occurs in the contralateral eye within a few months, but sometimes after several years. Inflammation and retinal necrosis are less severe in the later-affected eye, with less retinal detachment and a better visual outcome.