Iannetti Ludovico, Visioli Giacomo, Alisi Ludovico, Armentano Marta, Pirraglia Maria Pia, Accorinti Massimo, Di Martino Valerio, Gharbiya Magda
Ophthalmology Unit, Department of Head and Neck, Policlinico Umberto I University Hospital, Sapienza University of Rome, 00185 Rome, Italy.
Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
Biomedicines. 2024 Oct 11;12(10):2320. doi: 10.3390/biomedicines12102320.
: To evaluate the long-term anatomical and functional prognosis of patients with retinal detachment (RD) secondary to acute retinal necrosis (ARN) treated with pars plana vitrectomy (PPV). : This retrospective case series included 21 eyes from 21 patients with RD secondary to ARN. The study analyzed vitreous or aqueous biopsy results, the impact of antiviral therapy, time to retinal detachment, changes in visual acuity (VA), and anatomical and surgical outcomes. All cases underwent 23-gauge PPV with silicone oil tamponade, and an episcleral encircling band was used in 11 cases. All patients received systemic antiviral therapy at diagnosis. : Retinal reattachment was achieved in 91% of cases during follow-up, with an average follow-up period of 39.5 ± 36.8 months. The average time from ARN diagnosis to RD onset was 33.3 ± 27.5 days. VZV was detected in 10 eyes through PCR analysis. Significant differences in visual prognosis were found between macula-off and macula-on RD ( = 0.048). Eyes with optic nerve head inflammation had worse final VA ( = 0.010). No significant difference was observed between preoperative VA and VA at the end of follow-up ( = 0.665). : VZV was the primary virus associated with ARN-related RD. Early involvement of the macula and optic nerve in retinitis negatively impacted the final visual prognosis.
评估经玻璃体切割术（PPV）治疗的急性视网膜坏死（ARN）继发视网膜脱离（RD）患者的长期解剖和功能预后。：本回顾性病例系列纳入了21例ARN继发RD患者的21只眼。该研究分析了玻璃体或房水活检结果、抗病毒治疗的影响、视网膜脱离时间、视力（VA）变化以及解剖和手术结果。所有病例均接受23G玻璃体切割联合硅油填充，11例使用巩膜环扎带。所有患者在诊断时均接受全身抗病毒治疗。：随访期间91%的病例视网膜复位，平均随访时间为39.5±36.8个月。从ARN诊断到RD发作的平均时间为33.3±27.5天。通过PCR分析在10只眼中检测到水痘带状疱疹病毒（VZV）。黄斑脱离和黄斑未脱离的RD患者在视力预后方面存在显著差异（P = 0.048）。视神经乳头炎的眼睛最终视力较差（P = 0.010）。术前视力与随访结束时的视力之间未观察到显著差异（P = 0.665）。：VZV是与ARN相关RD相关的主要病毒。视网膜炎症中黄斑和视神经的早期受累对最终视力预后产生负面影响。
