Choi Eun Young, Lee Dong Hyun, Jun Jae Won, Byeon Suk Ho, Kim Sung Soo, Koh Hyoung Jun, Kim Min
Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Inha University College of Medicine, Incheon, Republic of Korea.
Clin Exp Ophthalmol. 2022 Jan;50(1):40-49. doi: 10.1111/ceo.14016. Epub 2021 Oct 11.
Acute retinal necrosis (ARN) is a fulminant necrotizing vaso-occlusive retinitis associated with a high incidence of vision loss. Prognostic factors associated with the treatment of ARN have not been comprehensively identified. This study aimed to determine therapeutic prognostic factors associated with long-term clinical outcomes in eyes with ARN.
This retrospective cohort study included patients with ARN who were treated between 2005 and 2019 in two tertiary ophthalmology departments in Seoul, Korea. Multiple logistic regression analysis was performed to investigate prognostic factors associated with late-onset retinal detachment (RD) and vision loss (<20/200).
Sixty-one eyes with ARN with an average follow-up of 63.5 months were included. Surgical intervention of vitrectomy (odds ratio [OR], 0.04; 95% confidence interval [CI], 0.004-0.47) and intraoperative prophylactic laser use (OR, 0.14; 95% CI, 0.02-0.81) were independently associated with a decreased risk of late RD. The factors independently associated with an increased risk of vision loss were worse initial visual acuity (OR, 3.28; 95% CI, 1.50-7.21), zone 1 involvement of necrotic retinitis (OR, 10.84; 95% CI, 1.62-72.41), and late-onset RD (OR, 5.38; 95% CI, 1.92-31.54).
Vitrectomy and/or prophylactic intraoperative laser treatment may be effective treatment options in preventing delayed RD associated with an increased risk of vision loss in eyes with ARN.
急性视网膜坏死（ARN）是一种暴发性坏死性血管闭塞性视网膜病变，视力丧失发生率高。与ARN治疗相关的预后因素尚未得到全面确定。本研究旨在确定与ARN患者长期临床结局相关的治疗预后因素。
这项回顾性队列研究纳入了2005年至2019年在韩国首尔的两个三级眼科科室接受治疗的ARN患者。进行多因素逻辑回归分析，以研究与迟发性视网膜脱离（RD）和视力丧失（<20/200）相关的预后因素。
纳入61只ARN眼，平均随访63.5个月。玻璃体切除术的手术干预（优势比[OR]，0.04；95%置信区间[CI]，0.004 - 0.47）和术中预防性激光使用（OR，0.14；95%CI，0.02 - 0.81）与迟发性RD风险降低独立相关。与视力丧失风险增加独立相关的因素包括初始视力较差（OR，3.28；95%CI，1.50 - 7.21）、坏死性视网膜病变累及1区（OR，10.84；95%CI，1.62 - 72.41）和迟发性RD（OR，5.38；95%CI，1.92 - 31.54）。
玻璃体切除术和/或术中预防性激光治疗可能是预防ARN患者视力丧失风险增加相关迟发性RD的有效治疗选择。
