Acute retinal necrosis: factors associated with anatomic and visual outcomes
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CLINICAL INVESTIGATION
Acute retinal necrosis: factors associated with anatomic and visual outcomes Chiharu Iwahashi-Shima • Atsushi Azumi • Nobuyuki Ohguro • Annabelle A. Okada Toshikatsu Kaburaki • Hiroshi Goto • Koh-Hei Sonoda • Kenichi Namba • Nobuhisa Mizuki • Manabu Mochizuki
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Received: 31 August 2012 / Accepted: 21 September 2012 / Published online: 2 November 2012 Ó Japanese Ophthalmological Society 2012
Abstract Purpose To examine the factors associated with anatomic and visual outcomes in Japanese patients with acute retinal necrosis (ARN). Methods One hundred four patients with ARN who were followed for more than 1 year at nine referral centers were reviewed. Retinal involvement at initial presentation was classified into four groups: zone 1 (posterior pole, n = 22), zone 2 (midperiphery, n = 54), zone 3 (periphery, n = 25), and unknown (n = 3). Forty-eight eyes underwent prophylactic vitrectomy before development of retinal detachment (vitrectomy group); 56 eyes were treated conventionally without prophylactic vitrectomy (observation group).
Results The retina was attached in 28 of 48 eyes (58.3 %) in the vitrectomy group and 42 of 56 eyes (75.0 %) in the observation group at the final visit (P = 0.071). At 1 year, 56 eyes (53.8 %) had a best-corrected visual acuity (BCVA) of 20/200 or worse. Multivariate logistic regression analyses identified zone 1 disease (odds ratio = 4.983) and optic nerve involvement (odds ratio = 5.084) as significantly associated with BCVA of 20/200 or worse. Among the zone 3 eyes, significantly (P = 0.012) more eyes in the observation group than in the vitrectomy group had an attached retina. Conclusions Prophylactic vitrectomy did not improve the final BCVA in any eyes. Zone 3 eyes had better outcomes without prophylactic vitrectomy.
C. Iwahashi-Shima N. Ohguro Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
K.-H. Sonoda Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
A. Azumi Department of Ophthalmology, Kobe University School of Medicine, Kobe, Japan
K.-H. Sonoda Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
N. Ohguro (&) Department of Ophthalmology, Osaka Koseinenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka 553-0003, Japan e-mail: [email protected]
K. Namba Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
A. A. Okada Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan T. Kaburaki Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan H. Goto Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
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N. Mizuki Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan M. Mochizuki Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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