Treatment Outcomes of Prophylactic Procedures in Acute Retinal Necrosis
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Purpose
To evaluate the efficacy of early vitrectomy versus prophylactic laser therapy in preventing acute retinal necrosis (ARN)-related retinal detachment (RD).
Methods
Patients diagnosed with ARN received intravenous treatment followed by oral antiviral therapy and tested positive for either varicella-zoster virus or herpes simplex virus between 2014 and 2024. These were included retrospectively. Treatment outcomes were compared among patients who received vitrectomy, prophylactic laser therapy, or none by Fisher’s exact test. ARN was graded by involved area into 1 (< 1/3), 2 (1/3 – 2/3), and 3 (> 2/3). The relation between ARN and RD was investigated with the Cochran-Armitage trend test.
Results
Twenty-eight patients (mean age, 53.1 years; 21 men; 25 VZV-positive) were analyzed. The rates of RD were 0% (0/7), 30.8% (4/13), and 62.5% (5/8) for patients receiving early vitrectomy, prophylactic laser therapy, and none, respectively. The finding suggests that the early vitrectomy was effective (p=0.026) but the prophylactic laser therapy was not (p=0.20) in preventing ARN-related RD. The rates of RD were 20.0% (2/10), 33.3% (2/6), and 41.7% (5/12) for ARN grades 1, 2, and 3, respectively, which indicates no significance (p=0.28).
Conclusion
Prophylactic vitrectomy may be an effective intervention for preventing RD in patients with ARN. However, the efficacy of prophylactic laser treatment remains inconclusive, indicating a need for further research to establish its role in RD prevention.
Conflict of interest
No
1
Last name
LIN
Initials of first name(s)
CP
Department
Ophthalmology
City
Taipei
Country
Taiwan
2
Last name
Yeh
Initials of first name(s)
PT
Department
Ophthalmology
City
Taipei
Country
Taiwan
3
Last name
Tew
Initials of first name(s)
TB
Department
Ophthalmology
City
Taipei
Country
Taiwan
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