Gore Jinal, Kelgaonkar Anup, Patel Anamika, Basu Soumyava, Pathengay Avinash
Uveitis and Retina Services, L V Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Odisha, India.
Uveitis and Retina Services, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India.
Indian J Ophthalmol. 2025 Jan 1;73(Suppl 1):S95-S99. doi: 10.4103/IJO.IJO_2168_24. Epub 2024 Dec 24.
To study clinical features, anatomical and visual outcomes in eyes having rhegmatogenous retinal detachment (RD) as the presenting feature of acute retinal necrosis (ARN).
We conducted a retrospective cohort study of patients with ARN (active/healed) and concomitant RD at the presenting visit.
The median age of patients was 36 years, with a male preponderance (9:1). Bilateral ARN was observed in 60% of cases, with 50% of patients testing positive for human immunodeficiency virus. The duration between the onset of symptoms and presentation was 3.66 ± 2.26 weeks. At presentation, 53.3% of eyes had active retinitis. Vitreoretinal surgery with silicone oil tamponade was performed for 14 eyes. Visual acuity significantly improved in 3 months (P = 0.0027). Poor visual outcomes were associated with optic nerve involvement. The mean duration of silicone oil tamponade was 7.41 ± 4.48 months. Complications included recurrent RD (14.29%), epiretinal membranes (14.29%), cystoid macular edema (21.4%), and retinal scarring with atrophy.
ARN with RD at presentation is a unique medical and surgical challenge, wherein good anatomical and functional outcomes could be achieved. The large size of retinitis and delayed presentation were the risk factors associated with poor visual outcomes.
研究以孔源性视网膜脱离（RD）为急性视网膜坏死（ARN）首发表现的眼部临床特征、解剖及视觉预后。
我们对初诊时患有ARN（活动期/愈合期）并伴有RD的患者进行了一项回顾性队列研究。
患者的中位年龄为36岁，男性居多（9:1）。60%的病例观察到双侧ARN，50%的患者人类免疫缺陷病毒检测呈阳性。症状出现至就诊的时间为3.66±2.26周。就诊时，53.3%的患眼有活动性视网膜炎。对14只眼进行了硅油填充的玻璃体视网膜手术。3个月时视力显著改善（P = 0.0027）。视觉预后不良与视神经受累有关。硅油填充的平均时间为7.41±4.48个月。并发症包括复发性RD（14.29%）、视网膜前膜（14.29%）、黄斑囊样水肿（21.4%）以及视网膜瘢痕伴萎缩。
初诊时伴有RD的ARN是一项独特的医学和外科挑战，可实现良好的解剖和功能预后。视网膜炎范围大及就诊延迟是与视觉预后不良相关的危险因素。
