ArticleIndian journal of ophthalmology2026
Acute retinal necrosis: Report 1-Epidemiology, clinical profile, and misdiagnosis from the largest Indian case series.
Article in Indian journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo describe the clinical profile of a large cohort of patients with acute retinal necrosis (ARN) in a tertiary eyecare institute from India.
methodsRetrospective analysis of all patients with ARN, visiting the uveitis clinic of a tertiary eye institute between 2010 and 2022.
resultThe study included 144 eyes of 119 patients with ARN (mean age 37.6 ± 15.8 years); 68.6% were males. A history of chickenpox was present in 12.6% and viral encephalitis in 9.2%. The common presenting symptom was blurred vision (94.9%), followed by redness (28.8%), pain (24.6%), and floaters (15.3%). Misdiagnosis occurred in 36.9% of cases. At presentation, 79.0% had unilateral disease, while 21.0% were bilateral, with many showing sequential involvement after a mean interval of 5.9 years. Anterior uveitis was documented in 30.5% of eyes, vitritis grade ≥ II in 70.8%, and all four quadrants of retinitis in 47.8%. Retinal vasculitis and optic nerve involvement were noted in 84.0% and 39.6%, respectively. Polymerase chain reaction detected herpes simplex virus and varicella-zoster virus with equal frequency (28.6% each); dual infection was found in 5.0%. Most patients received intravenous acyclovir induction followed by oral antivirals, with valacyclovir used in 80.7%. The mean treatment duration was 5 months. Follow-up averaged 2 years, during which the visual acuity declined from 1.58 to 1.89 logMAR. Major complications included cataract (79.2%), retinal detachment (72.5%), hypotony (48.6%), and optic atrophy (25%).
conclusionARN remains a devastating viral retinitis which is frequently underrecognized in its early stages.
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