Prophylactic Laser Photocoagulation and Vitrectomy for Acute Retinal Necrosis

Between 1995 and 2013, the charts of 20 patients (21 eyes) with a clinical diagnosis of ARN and a complete ophthalmic examination at National Taiwan University Hospital were reviewed. The study was approved by the Ethics Committee and Institutional Review Board of National Taiwan University Hospital.

The clinical data recorded included patient demographics, refractive error, lens status, best corrected visual acuity (BCVA), all treatments and retinal anatomical status. Visual acuities and examination findings were recorded at presentation and subsequent follow-up periods for at least 6 months. The area of retina involved was determined by review of retinal drawings and fundus photos by single reader.

All the patients were admitted for intravenous injection of Acyclovir (30mg/kg/day, in 3 divided doses) for 10-14 days and then shifted to oral Acyclovir (30mg/kg/day) at least for further 10-14 days. Systemic corticosteroid and Aspirin were also given. Prophylactic laser photocoagulation was arranged on normal retina to surround the posterior edge of the active lesions if the media was clear enough to approach. If vitritis persisted without improvement under systemic antiviral agent or retinal detachment was noted, vitrectomy would be performed. Visual acuities and retinal anatomical results were recorded during follow-up after procedures. The visual acuity was converted to logarithm of the minimum angle of resolution (logMAR) values for statistical analysis.

Statistical analysis The continuous values are expressed as means ± standard deviation (SD). The differences among the continuous variables were assessed using the Mann-Whitney U test. Non-continuous variables were analyzed by Fisher's exact test. The level of statistical significance was set at p < 0.05.