Clinical Characteristics, Management, and Factors Associated with Poor Visual Prognosis of Acute Retinal Necrosis

Purpose: To identify the clinical characteristics of acute retinal necrosis (ARN) and clarify factors associated with poor visual prognosis. Methods: a nationwide multi-center retrospective chart review study was performed in Japan using data from the medical records of 149 consecutive ARN patients. Demographics, ocular signs, virologic testing of intraocular fluids, and treatment were examined. Factors associated with poor visual prognosis were investigated by regression analysis. Results: At initial presentation, anterior chamber cells or mutton-fat keratic precipitates (97%), unilaterality (93%), and yellow-white retinal lesions (86%) were recognized. In the clinical course, rapid circumferential expansion of retinal lesions (39%), development of retinal break or retinal detachment (55%), and optic atrophy (43%) were recorded. Four variables were identified as associated with poor visual prognosis. Conclusions: The present study identified clinical characteristics and factors associated with poor visual prognosis of ARN.

Automated summary

This study retrospectively reviewed the clinical characteristics of 149 consecutive ARN patients and investigated factors associated with poor visual prognosis. Anterior chamber cells or mutton-fat keratic precipitates, unilateral involvement, and yellow-white retinal lesions were commonly observed at initial presentation. Rapid circumferential expansion of retinal lesions, development of retinal break or retinal detachment, and optic atrophy were recorded during the clinical course. Four variables were identified as predictors of poor visual prognosis.