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Posters

Pattern of acute retinal necrosis in a referral center in Tunisia, North Africa

Poster Details

First Author: R.Kahloun TUNISIA

Co Author(s):    W. Ammari   O. Haj Taher   A. Khlifi   S. Attia   R. Messaoud   M. Khairallah   0   0 0   0 0   0 0   0 0

Abstract Details



Purpose:

To describe the clinical features and the visual outcome of acute retinal necrosis (ARN) syndrome in a referral center.

Setting:

Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.

Methods:

The charts of 12 patients (12 eyes) with newly diagnosed ARN syndrome were retrospectively reviewed.

Results:

The mean age was 35.7 years (range: 17-70 years). Eight of the patients were men and 4 were women. All patients were immunocompetent. Peripheral retinitis was associated with macular involvement in 3 eyes (25%). Polymerase chain reaction (PCR) results showed Herpes simplex virus-1 in 4 eyes (33.3% ), Varicella-Zoster virus in 3 eyes (25% ), and were negative in 5 eyes (41.7% ). All patients were treated with intravenous aciclovir, followed by oral valaciclovir for a mean duration of 3.8 months. Intravitreal injections of ganciclovir were given in 2 eyes. The mean follow-up was 8.4 months (range, 6 to 16 months). During the follow-up, no patient developed ARN in the fellow eye, but retinal detachment (RD) occurred in 3 eyes (25%). Final visual acuity was 20/40 (0.3 log MAR) or better in three eyes (25%) and 20/200 (1 log MAR) or worse in seven eyes (58.3%). Factors associated with poor visual outcome were duration between onset and treatment > 14 days (p=0.015), macular involvement (p=0.045), development of RD (p=0.018) and 25-50% of retinal involvement (p=0 .045).

Conclusions:

ARN carries a poor visual prognosis in Tunisia. RD developed in one-fourth of cases despite antiviral treatment. Early diagnosis and prompt management are mandatory to improve visual outcome.

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