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

ABSTRACT

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.

KEYWORDS:

• Acute retinal necrosis
• uveitis
• nationwide survey
• prognostic factor
• ocular characteristics

Disclosure of interest

H.T. reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study; personal fees from Santen Pharmaceutical Co., Ltd., personal fees from Novartis Pharma KK (Japan), personal fees from AbbVie Japan, Inc., personal fees from Senju Pharmaceutical Co., Ltd., personal fees from Eisai Co., Ltd., and personal fees from Otsuka Pharmaceutical Co., Ltd., outside the submitted work; a patent, Japanese Patent Application No. 2019-107483, is pending.

H.G. reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study.

K.N. reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study; grants from AbbVie Japan, Inc., Mitsubishi Tanabe Pharma, and Eisai Co., Ltd., and personal fees from HOYA corporation, Alcon, Pfizer inc., Novartis Pharma KK (Japan), Kowa Company, Ltd., Senju Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma, Eisai Co., Ltd., AbbVie Japan, Inc., and Santen Pharmaceutical Co., Ltd. outside the submitted work.

N.M. reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study.

A.A.O reports grants from the Ministry of Health, Labour and Welfare of Japan, grants and personal fees from Santen Pharmaceutical Co., Ltd., grants and personal fees from Mitsubishi Tanabe Pharma Corporation, personal fees from AbbVie Japan, Inc., grants and personal fees from Novartis Pharma KK (Japan), and personal fees from Daiichi-Sankyo during the conduct of the study; personal fees from Bayer Healthcare AG, grants and personal fees from Bayer Yakuhin Ltd. (Japan), personal fees from Astellas Japan, and personal fees from Senju Pharmaceutical Co., Ltd., outside the submitted work.

N.O. reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study.

K-H.S reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study.

M.T. reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study.

H.K., R.K., K.M., E.S., H.T., and R.Y. have nothing to disclose.

T.K. reports personal fees from AbbVie, Inc, personal fees from Alcon Laboratories, Inc., personal fees and non-financial support from Cosmic Corp, personal fees from Eisai, Co. Ltd, personal fees from Kowa, Co. Ltd., personal fees from Mitsubishi Tanabe Pharma, personal fees from Santen, Inc., personal fees from Senju, Inc., and personal fees from Teijin Pharma, outside the submitted work.

M.M. reports grants from the Ministry of Health, Labour and Welfare of Japan, during the conduct of the study; a patent Japanese Patent Application No. 2019-107483 is pending.

SUPPLEMENTARY MATERIAL

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This study was supported by a Health and Labour Sciences Research Grant for research on rare and intractable diseases from the Ministry of Health, Labour and Welfare of Japan.