gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Diagnosis and management of acute retinal necrosis

Meeting Abstract

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  • corresponding author C. Horstmann - Department of Ophthalmology, Kiel
  • B. Nölle - Department of Ophthalmology, Kiel
  • A. Bunse - Department of Ophthalmology, Kiel
  • J. Roider - Department of Ophthalmology, Kiel

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSO.05.12

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Veröffentlicht: 22. September 2004

© 2004 Horstmann et al.
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Acute retinal necrosis (ARN) is a rare inflammation of the peripheral retina caused by herpes viruses.


We report on 18 immuncompromised patients between 1987 and 2004 with the diagnosis of acute retinal necrosis.The symptoms were decreased vision resulting from vitreous opacification and acute anterior uveitis with necrotizing retinitis. All patients were treated with the virostatic agent Acyclovir (3x10 mg / kg / d) and prednisolone (1 mg / kg / d). Four out of seven patients received intravitreal zovirax infusions. Seven patients underwent a vitrectomy, 5 with silicone oil filling and 2 patients with gas filling.The other 10 patients were treated with systemic Acyclovir and prednisolone. One patient showed at presentation a retinal detachment, he underwent vitreoretinal surgery with sclera buckling and silicone oil tamponade.


16 out of 18 vitreous samples were tested positive for herpes viruses. In all patients early vitrectomy stopped the development of the necrotic areas. 5 out of 7 patients developed retinal detachment. Enucleation had to be carried out in one eye with persistent phthisis bulbi. There were no additional operations after stabilistion of the retina was achieved. After half a year the visual acuity was 0,24 in average (median 0,2). All 10 from the non vitrectomy group developed retinal detachment with progression of the necrotized areas. In 5 patients a vitrectomy due to PVR-detachment was necessary. Mean VA was 0,09 (median 0,05). The fellow eye was free of ARN-symptoms in17 / 18 in the follow up period, either no inflammation of the fellow eye developed under therapy.


An early vitrectomy and a intravitreal infusion with Acyclovir prevent further progression and leads to better visual results.The visual acuity is limited by optic neuropathy.