Advances in the management of acute retinal necrosis

• Type of Material: Article
• Authors: Jessica G. Shantha, Emory University; Heather M. Weissman, Emory University; Matthew Debiec, Emory University; Thomas A. Albini, University of Miami; Steven Yeh, Emory University
• Language: English
• Date: 2015
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Wolters Kluwer Health, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/IIO.0000000000000077
• Title of Journal or Parent Work: International Ophthalmology Clinics
• ISSN: 0020-8167
• Volume: 55
• Issue: 3
• Start Page: 1
• End Page: 13
• Grant/Funding Information: upported in part by an unrestricted departmental grant (Department of Ophthalmology, Emory University School of Medicine) from Research to Prevent Blindness, Inc., New York, and by NIH/NEI core grant P30-EY06360 (Department of Ophthalmology, Emory University School of Medicine).; Dr. Yeh is supported by an unrestricted Alcon Young Investigator Research Grant.
• Keywords: Fibrinolytic Agents; Retinal Necrosis Syndrome, Acute; Ophthalmology; Humans; Intravitreal Injections; Light Coagulation; Drug Therapy, Combination; Antiviral Agents; Vitrectomy; Disease Management; Adrenal Cortex Hormones
• Research Categories: Health Sciences, Opthamology

Abstract

Acute retinal necrosis is a viral syndrome characterized by a panuveitis with necrotizing retinitis that may be complicated by retinal detachment, vaso-occlusion, optic neuropathy, and other causes of decreased visual acuity. Polymerase chain reaction testing provides a rapid and sensitive method of identifying the viral etiology of acute retinal necrosis, which is most commonly caused by herpes simplex virus type 1, herpes simplex virus type 2, and varicella zoster virus. Prompt diagnosis and treatment is paramount to prevent further vision loss. We review the management of acute retinal necrosis including systemic, local intravitreal, and combination antiviral medications. We also discuss the appropriate and inappropriate use of corticosteroids, laser retinopexy, surgical therapy, and other adjunctive measures.