Pattern of Acute Retinal Necrosis in a Referral Center in Tunisia, North Africa

Ocul Immunol Inflamm. 2015;23(5):371-7. doi: 10.3109/09273948.2014.925125. Epub 2014 Jun 19.

Abstract

Purpose: To describe the pattern of acute retinal necrosis (ARN) syndrome in a referral center in Tunisia.

Methods: Retrospective review of the charts of 12 patients (12 eyes).

Results: Necrotizing retinitis involved >50% of the retina in 33.3% of eyes. Polymerase chain reaction on aqueous humor sample identified herpes simplex virus-1 in 4 eyes (33.3%) and varicella zoster virus in 3 eyes (25%), and was negative in 5 eyes (41.7%). All patients received intravenous acyclovir, followed by oral antivirals. Follow-up ranged from 6 to 16 months. Retinal detachment (RD) occurred in 3 eyes (25%), but no patient developed bilateral ARN. Final visual acuity was 20/200 or worse in 7 eyes (58.3%). Delay in diagnosis (p = 0.015), macular involvement (p = 0.045), development of RD (p = 0.018), and 25-50% of retinal involvement (p = 0.045) were associated with a worse visual outcome.

Conclusion: ARN carries poor visual prognosis in Tunisia.

Keywords: Acute retinal necrosis; North Africa; herpes simplex virus; herpes zoster virus; polymerase chain reaction; retinal detachment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • DNA, Viral / analysis
  • Eye Infections, Viral / epidemiology*
  • Eye Infections, Viral / virology
  • Female
  • Follow-Up Studies
  • Herpes Simplex / complications*
  • Herpes Simplex / epidemiology
  • Herpes Simplex / virology
  • Herpes Zoster Ophthalmicus / complications*
  • Herpes Zoster Ophthalmicus / epidemiology
  • Herpes Zoster Ophthalmicus / virology
  • Herpesvirus 1, Human / genetics
  • Herpesvirus 3, Human / genetics
  • Humans
  • Incidence
  • Male
  • Referral and Consultation*
  • Retinal Necrosis Syndrome, Acute / epidemiology*
  • Retinal Necrosis Syndrome, Acute / etiology
  • Retinal Necrosis Syndrome, Acute / virology
  • Retrospective Studies
  • Tunisia

Substances

  • DNA, Viral