ArticleOphthalmology. Retina2021
Outcomes of Combination Systemic and Intravitreal Antiviral Therapy for Acute Retinal Necrosis.
Article in Ophthalmology. Retina, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 23 citations in OpenAlex.
- [Acute unilateral loss of vision with retrobulbar pain in a patient with known multiple sclerosis-A clear diagnosis?]Die Ophthalmologie · 2026Article
- Herpesvirus-Associated Visual Impairment: Clinical Features, Etiological Spectrum, and Treatment Outcomes in Consecutive Patients from a Tertiary Neurological Clinic.Brain sciences · 2026Article
- Acute Retinal Necrosis versus Progressive Outer Retinal Necrosis.Current ophthalmology reports · 2026Article
- Off-label prescribing in ophthalmology: a retrospective analysis.Frontiers in pharmacology · 2026Article
- Clinical characteristics and outcomes of acute retinal necrosis at different stages: a retrospective study.BMC ophthalmology · 2025Article
- Varicella Zoster Virus-Induced Retinitis and Retinal Detachment in an Immunocompetent Patient: A Case Report.The American journal of case reports · 2025Article
- Risk factors and prognostic factors associated with retinal detachment and visual outcomes in acute retinal necrosis.BMC ophthalmology · 2024Article
- Diagnostic and therapeutic challenges in acute retinal necrosis; an update.Eye (London, England) · 2024Review
- Infectious Eye Diseases and Prevention Control.Microorganisms · 2023Article
- Acute retinal necrosis. Management and visual outcomes: a case series.International journal of retina and vitreous · 2022Article
- Update on the Management of Uveitic Macular Edema.Journal of clinical medicine · 2021Review
- Cytopathology of Vitreous Specimens in Acute Retinal Necrosis.Ocular immunology and inflammationArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
purposeDetermine the efficacy of combination intravitreal and systemic antiviral therapy for the treatment of acute retinal necrosis (ARN) and risk factors impacting visual acuity (VA) and retinal detachment (RD) outcomes.
designSingle-center retrospective case series.
participantsPatients with an ARN diagnosis based on clinical features and polymerase chain reaction confirmation who were treated at a tertiary referral, university-based academic practice.
methodsPatient records were reviewed for demographic information including age and gender. Snellen VA, disease findings including RD outcomes, optic nerve involvement, and treatments were recorded. Incidence rates of major VA and RD outcomes were calculated based on the number of events and exposure times. Cox proportional hazards regression modeling and survival analyses were used to identify factors related to VA and RD outcomes over time.
main outcome measuresLogarithm of the minimal angle of resolution VA, 2-line or more VA gain, severe vision loss (SVL) of 20/200 or worse, RD development, and fellow eye involvement.
resultsTwenty-three eyes of 21 patients (11 male, 10 female) were reviewed. Thirteen patients (62%) had herpes simplex virus and 8 patients (38%) had varicella zoster virus. The event rate for 2-line or more VA gain was 0.49 events/eye-year (95% confidence interval [CI], 0.26-0.86 events/eye-year), whereas the rate of SVL was 0.61 events/eye-year (95% CI, 0.34-1.02 events/eye-year). Retinal detachment development was observed at a rate of 0.59 events/eye-year (95% CI, 0.33-1.00 events/eye-year). Thirteen of 23 eyes (57%) demonstrated RD with a mean time of 120 days after ARN diagnosis. With each additional quadrant of retina involved, a greater risk of RD development over time was observed (hazard ratio, 2.21; 95% CI, 1.12-4.35). Nine percent of eyes progressed with additional quadrantic involvement, despite combination systemic and intravitreal antiviral therapy; however, none of the 19 patients demonstrating unilateral ARN showed fellow-eye involvement after initiation of therapy.
conclusionsCombination intravitreal and systemic antiviral therapy for ARN can be effective in improving VA and limiting retinitis progression. Each additional quadrant of retina involved was associated with a 2.2-fold greater risk of RD, which may impact monitoring, timing of intervention, and patient counseling.
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