Abstract
Objectives
To analyze the prognostic factors for visual acuity in acute retinal necrosis syndrome (ARN) patients treated non-surgically.
Methods
The clinical data of ARN patients who visited our hospital from January 2010 to January 2023 were retrospectively analyzed.
Results
Twenty-four patients (29 eyes) were included. Aqueous humor samples were collected from 20 out of 29 eyes, and PCR confirmed that 85% (17/20) of the eyes had VZV infection, 10% (2/20) had CMV infection, and 5% (1/20) had HSV infection. All patients were treated with intravenous antiviral agents. Intravitreal ganciclovir and oral corticosteroids were given according to the patients’ wishes. A comparison of visual acuity at the last follow-up with that at the first visit revealed that 16 (55.2%) eyes improved and 13 (44.8%) did not improve. Logistic regression analysis revealed that risk factors for failure to improve vision after treatment included retinal detachment, necrotizing retinitis involving the posterior pole, and arteritis involving the large retinal arteries. The VZV viral load in the aqueous humor at initial presentation was significantly associated with visual prognosis (P = 0.013), retinal detachment (P = 0.019) and the extent of retinal necrosis(P = 0.03). The NLR of VZV-infected patients at first presentation was significantly correlated with the prognosis of visual acuity (P = 0.033) and retinal detachment (P = 0.003).
Conclusions
At initial presentation, a high NLR and high viral DNA copy number in the aqueous humor were risk factors for poor visual acuity in VZV-infected ARN patients.