Retinal detachment in patients with acute retinal necrosis: A case series

Background: Acute retinal necrosis is a rare and severe infectious ocular disease frequently complicated by retinal detachment. Patients and Methods: Records of six consecutive eyes from five patients with acute retinal necrosis were reviewed. Results: PCR analysis of intraocular fluids was positive for Varizella zoster virus, Herpes virus 1 or 2. Treatment consisted of systemic acyclovir, systemic and local corticosteroids as well as aspirin. Progression of the necrosis could be effectively controlled, however all eyes developed retinal detachment within 55 +/- 24 days. Retinal surgery including pars plana vitrectomy, encircling scleral buckling, liquid silicone or gas filling led to retinal reattachment in all patients during the follow-up time (590 +/- 242 days). The mean visual acuity at the end of the follow-up time was 0.4 +/- 0.3. Conclusions: The diagnosis of acute retinal necrosis is reliably confirmed using PCR analysis of intraocular fluids. Currently available treatments are effective in stopping progression of the necrosis. There is, however, a high risk of retinal detachment, which can be successfully treated with vitreoretinal surgery.