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Acute retinal necrosis
Uvea
Key Points
- •ARN is an ophthalmic emergency caused by herpesviruses (VZV most common) in immunocompetent patients - defined by the AUS criteria: peripheral retinal necrosis, circumferential spread, occlusive arteritis, prominent vitritis
- •Immediate IV aciclovir 10 mg/kg TDS for 10–14 days, then oral valaciclovir 1g TDS for >=6 weeks (protects fellow eye from 35% to <5% involvement)
- •Retinal detachment occurs in 75% without prophylactic laser - apply laser barricade posterior to the necrosis edge as soon as feasible
- •Key differentiator from CMV retinitis: ARN has prominent vitritis and arteritis in an immunocompetent host; CMV has minimal vitritis in CD4 <50
- •Aqueous/vitreous PCR for HSV-1, HSV-2, VZV, CMV is the gold standard for confirming the viral aetiology
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Keep reading Acute retinal necrosis
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations