Clinical findings, outcomes following management and complications of acute retinal necrosis: the experience of a tertiary eye centre in Saudi Arabia

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PURPOSE: To study the clinical picture, outcomes and the complications of acute retinal necrosis (ARN) in a tertiary eye hospital. METHODS: This is retrospective chart review of all patients who were diagnosed with ARN and were treated and followed up at King Khaled Eye Specialist Hospital (KKESH). Details of clinical examinations, Polymerase Chain Reaction (PCR) results, systemic and topical treatments, complications and managements of complications were obtained. RESULTS: Twenty eight eyes of 26 patients were included. The results of PCR were positive in 22 eyes. Systemic antiviral therapy with intravenous Acyclovir 10 mg/Kg three times daily was given to all cases. Eight patients were treated with intravitreal ganciclovir injections. Fifteen eyes (56.3%) had rhegmatogenous retinal detachment (RRD) and 11 of them had surgical interventions. The risk of developing RRD was significantly high in severe vitritis (P = 0.007, OR = 3.825), diffuse or multifocal retinitis (P = 0.010, OR = 1.04) and the larger extent of retinitis (P = 0.016). The final visual outcome was worse among eyes which developed RRD (LogMAR 1.6 ± 0.94, Snellen = 20/800) than eyes which did not develop RRD (LogMAR 0.81 ± 0.84, Snellen = 20/125) and the difference was statistically significant (P = 0.031). CONCLUSION: The visual outcomes of ARN are significantly worse in eyes which develop RRD. More severe and larger extent of posterior segment involvement confer higher risks of RRD development in ARN.

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