Original ArticleAcute Retinal Necrosis: Virological Features Using Quantitative Polymerase Chain Reaction, Therapeutic Management, and Clinical Outcomes
Section snippets
Methods
This study was a retrospective observational case series of 24 patients with ARN in the Departments of Ophthalmology of the Croix-Rousse and Edouard Herriot Teaching Hospitals (Lyon, France) who were treated and followed up between May 2010 and December 2016. Cases were identified from the virology department database that contained the qPCR results of herpes viruses from samples of the aqueous humor (AH). All patients met the criteria for ARN defined by the American Uveitis Society.23 Written
Results
The initial patient characteristics are reported in Table 1.
Discussion
To the best of our knowledge, the present study is the largest series to describe the evolution of the viral load of ARN using qPCR during treatment. The antiviral treatment regimen used was largely homogeneous and included initial intravenous therapy combined with biweekly IVTs, followed by oral therapy with weekly IVTs. This treatment protocol yielded good outcomes in terms of VA and the RD rate.
Half of the included patients had a history of herpes infection, making it an important and often
References (59)
- et al.
Viral causes of the acute retinal necrosis syndrome
Am J Ophthalmol
(2000) - et al.
Acute retinal necrosis: features, management, and outcomes
Ophthalmology
(2007) - et al.
Intravitreal antiviral injections as adjunctive therapy in the management of immunocompetent patients with necrotizing herpetic retinopathy
Am J Ophthalmol
(2000) - et al.
Acute retinal necrosis: the effects of intravitreal foscarnet and virus type on outcome
Ophthalmology
(2010) - et al.
Treatment of acute retinal necrosis
Ophthalmology
(2010) - et al.
Genotypic detection of acyclovir-resistant HSV-1: characterization of 67 ACV-sensitive and 14 ACV-resistant viruses
Antiviral Res
(2008) - et al.
Clinical characteristics of acute HSV-2 retinal necrosis
Am J Ophthalmol
(2004) - et al.
Resistance of herpesviruses to antiviral drugs: clinical impacts and molecular mechanisms
Drug Resist Updat
(2002) - et al.
The acute retinal necrosis syndrome. Part 1: clinical manifestations
Ophthalmology
(1982) - et al.
Retinal detachment following the acute retinal necrosis syndrome
Ophthalmology
(1984)
[Viral cause and management of necrotizing herpetic retinopathies]
J Fr Ophtalmol
[Acute retinal necrosis: clinical presentation, treatment, and prognosis in a series of 22 patients]
J Fr Ophtalmol
Treatment of acute retinal necrosis syndrome with oral antiviral medications
Ophthalmology
Acute retinal necrosis: clinical features, early vitrectomy, and outcomes
Ophthalmology
Acute retinal necrosis: presenting characteristics and clinical outcomes in a cohort of polymerase chain reaction–positive patients
Am J Ophthalmol
Treatment of the acute retinal necrosis syndrome with intravenous acyclovir
Ophthalmology
Resistance of herpes simplex viruses to acyclovir: an update from a ten-year survey in France
Antiviral Res
Primary treatment of acute retinal necrosis with oral antiviral therapy
Ophthalmology
Unilateral acute uveitis with retinal periarteritis and detachment
Rinsho Ganka
[Acute retinal necrosis syndrome. Lausanne cases, review of the literature and new physiopathogenetic hypothesis]
Klin Monbl Augenheilkd
Acute retinal necrosis: clinical features, management and outcomes – a 10 year consecutive case series
Ocul Immunol Inflamm
Acute retinal necrosis: a case series with clinical features and treatment outcomes
Clin Exp Ophthalmol
Polymerase chain reaction-based assays of vitreous samples for the diagnosis of viral retinitis. Use in diagnostic dilemmas
Ophthalmology
Use of multiplex PCR and real-time PCR to detect human herpes virus genome in ocular fluids of patients with uveitis
Br J Ophthalmol
Polymerase chain reaction as a rapid diagnostic tool for therapy of acute retinal necrosis syndrome
J Med Virol
Real-time quantitative polymerase chain reaction diagnosis of infectious posterior uveitis
Arch Ophthalmol
Comparison of quantitations of viral load in varicella and zoster
J Clin Microbiol
Quantitative analysis of herpes simplex virus DNA in cerebrospinal fluid of children with herpes simplex encephalitis
J Med Virol
Correlation of varicella-zoster virus copies and final visual acuities of acute retinal necrosis syndrome
Graefes Arch Clin Exp Ophthalmol
Cited by (27)
Antiviral treatment for acute retinal necrosis: A systematic review and meta-analysis
2024, Survey of OphthalmologyComment on: Acute Retinal Necrosis: Virological Features Using Quantitative Polymerase Chain Reaction, Therapeutic Management, and Clinical Outcomes
2020, American Journal of OphthalmologyHuman encephalitis complicated with bilateral acute retinal necrosis associated with pseudorabies virus infection: A case report
2019, International Journal of Infectious DiseasesCitation Excerpt :Although NGS testing was negative for PRV in the vitreous humor of the right eye, the patient’s vision in the right eye gradually and continuously became impaired, owing to retinal detachment and a complicated cataract; meanwhile, retinal detachment recurred in the left eye after vitrectomy. Hafidi et al. found that numerous and prolonged intravitreal antiviral injections, used as adjunctive therapy, could improve the prognosis of ARN patients by decreasing the risk of retinal detachment and improving visual acuity (Hafidi et al., 2019). This discovery provides a new idea for the treatment of our patients in the future.
Clinical characteristics and management outcomes of acute retinal necrosis
2023, Scientific ReportsComparison of the efficiency of aqueous humor and corneal samples for the viral DNA detection at different layers in herpesvirus-positive keratoplasty patients
2023, Chinese Journal of Experimental Ophthalmology
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