Retrospective Analysis Of Cases In The Terminal Stage Of Acute Retinal Necrosis

ObjectiveTo investigate the diagnosis and treatment of acute retinal necrosis(ARN). To explore the early diagnosis and appropriate treatment of ARN, so as to improve its' prognosis.MethodsWe studied the cases of ARN in the inpatients of the 2nd Affiliated Hospital of Zhejiang University from January 2008 to March 2010, and we analysed these cases' duration,diagnosis and treatment.ResultsIn the the two years from January 2008 to March 2010, there were 9 cases of ARN (10 eyes) operated for retinal detachment in our hospital.8 were male and 1 was female. The age range was 27 to 63 years (mean 50.4 years).9 cases were unilateral, with 1 patient presenting with bilateral ARN. The visual acuity prior to operation of one case was 0.02,5 cases were hand move to hand move/20cm,4 eyes were light perception. 7 cases (8 eyes) were misdiagnosed as conjunctivitis,uveitis,vitreous opacities and glaucomatocyclitic crisis.3 cases (3 eyes) didn't accept antiviral therapy.10 eyes developed retinal detachment after 7 to 120 days (mean 50.9 days). 10 eyes accepted vitrecomy and silicone filling, and 8 eyes combined with laser photocoagulation,3 eyes combined with phacoemulsification and IOL implantation. Retinal reattachment was achieved in all patients. The vision of postoperation was light perception to 0.15. Silicone oil was removed at eight months after operation in one eye, and at five months after operation in one eye. Of these two eyes, the retina was reattached, and the vision was 0.1 and 0.15.ConclusionARN is a rare condition which can potentially lead to poor visual outcomes. It has a high rate of misdiagnosis. Without carefully fundus examination, ARN cases can be misdiagnosed as uveitis and glaucomatocyclitic crisis. Terminal can have retinal detachment. Vitrectomy and silicone oil filling is effective in retinal reattachment, and the postoperative visual acuity can be improved to some extent.