Journal List > J Korean Ophthalmol Soc > v.49(3) > 1008222

J Korean Ophthalmol Soc. 2008 Mar;49(3):519-524. Korean.
Published online March 20, 2008.  https://doi.org/10.3341/jkos.2008.49.3.519
Copyright © 2008 The Korean Ophthalmological Society
Vitrectomy and Silicone Oil Tamponade to Prevent Retinal Detachment in Severe Acute Retinal Necrosis Syndrome
Ja Young Jung, M.D. and Tae Gon Lee, M.D.
Myung-Gok Eye Research Institute, Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea.

Address reprint requests to Tae Gon Lee, M.D. Department of Ophthalmology, Konyang University, Kim's Eye Hospital, #156 4ga, Youngdeungpo-dong, Youngdeungpo-gu, Seoul 150-034, Korea. Tel: 82-2-2639-7777, Fax: 82-2-2633-3976, Email: idoc@netsgo.com
Received January 04, 2007; Accepted September 04, 2007.

Abstract

Purpose

We report the results in two patients received prophylactic surgery to prevent retinal detachment in the severe acute retinal necrosis.

Case summary

Two patients in whom the presumptive diagnosis of the severe acute retinal necrosis were concomitantly treated with antiviral agents, systemic steroids and anti platelet therapy. We performed vitrectomy and silicone oil tamponade as the prophylactic surgical procedure for retinal detachments. The retinas remained attached in all patients over a follow up periods.

Conclusions

Retinal detachment secondary to acute retinal necrosis has a complex nature and usually results in severe visual loss. A combination of vitrectomy and silicone oil tamponade may be effective prophylaxes against retinal detachment in acute retinal necrosis.

Keywords: Acute retinal necrosis; Surgery therapy

Figures


Figure 1
Initial fundus photographs of the left eye (Case 1) show confluent areas of peripheral retinal whitening with overlying retinal hemorrhages and prominent vascular sheathing.
Click for larger image


Figure 2
Fundus photographs of the left eye (Case 1). Seven months after surgery. Retina remained attached well. The posterior margin of diseased retina appeared demarcated by laser scars. No retinal breaks within the areas of retinal necrosis were seen.
Click for larger image

References
1. Clarkson JG, Blumenkranz MS, Culbertson WW, et al. Retinal detachment following the acute retinal necrosis syndrome. Ophthalmology 1984;91:1665–1668.
2. Blumenkranz MS, Culbertson WW, Clarkson JG, Dix R. Treatment of the acute retinal necrosis syndrome with intravenous acyclovir. Ophthalmology 1986;93:296–300.
3. Culbertson WW, Blumenkranz MS, Pepose JS, et al. Varicella zoster virus is a cause of the acute retinal necrosis syndrome. Ophthalmology 1986;93:559–569.
4. Culbertson WW, Blumenkranz MS, Haines H, et al. The acute retinal necrosis syndrome: Histopathology and etiology. Ophthalmology 1982;89:1309–1325.
5. Freeman WR, Thomas EL, Rao NA, et al. Demonstration of herpes group virus in acute retinal necrosis syndrome. Am J Ophthalmol 1986;102:701–709.
6. Mastsuo T. Vitrectomy and silicone oil tamponade as an initial surgery for retinal detachment after acute retinal necrosis syndrome. Ocul Immunol Inflamm 2005;13:91–94.
7. McDonald HR, Lewis H, Kreiger AE, et al. Surgical management of retinal detachment associated with the acute retinal necrosis syndrome. Br J Ophthalmol 1991;75:455–458.
8. Lau CH, Missotten T, Salzmann J, Lightman SL. Acute retinal necrosis features, management, and outcomes. Ophthalmology 2007;114:756–762.
9. Culbertson WW, Clarkson JG, Blumenkranz M, Lewis ML. Acute retinal necrosis. Am J Ophthalmol 1983;96:683–685.
10. Han DP, Lewis H, Williams GA, et al. Laser photocoaculation in the acute retinal necrosis syndrome. Arch Ophthalmol 1987;105:1051–1054.
11. Sternberg P Jr, Han DP, Yeo JH, et al. Photocoagulation to prevent retinal detachment in acute retinal necrosis. Ophthalmology 1988;95:1389–1393.
12. Hudde T, Althaus C, Sundmacher R. Acute retinal necrosis syndrome. Argon laser coagulation for prevention of rhegmatogenous retinal detachment. Ophthalmologe 1998;95:473–477.
13. Park JH, Kang SW, Lee JS, Min WK. Vitreous Surgery for Retinal Detachment associated with Acute Retinal Necrosis Syndrome. J Korean Ophthalmol Soc 1995;36:344–350.
14. Ahmadieh H, Soheilian M, Azarmina M, et al. Surgical management of retinal detachment secondary to acute retinal necrosis : clinical features, surgical technique, and long term results. Jpn J Ophthalmol 2003;47:484–491.
15. Crapotta JA, Freeman WR, Feldman RM, et al. Visual outcome in acute retinal necrosis. Retina 1993;13:208–213.
16. Ms Blumenkranz;WW. Culbertson;JG. Clarkson,R Dix.Treatment of the acute retinal necrosis syndrome with intravenous acyclovir. Ophthalmology 1986;93:296–300.
17. Blumenkranz M, Clarkson J, Culbertson WW, et al. Vitrectomy for retinal detachment associated with acute retinal necrosis. Am J Ophthalmol 1988;106:426–429.
18. Sergott RC, Belmont JB, Savino PJ, et al. Optic nerve involvement in the acute retinal necrosis syndrome. Arch Ophthalmol 1985;103:1160–1162.
19. Sergott RC, Anand R, Belmont JB, et al. Acute retinal necrosis neuropathy, clinical profile and surgical therapy. Arch Ophthalmol 1989;107:692–696.
20. Matsuo T, Morimoto K, Matsuo N. Factors associated with poor visual outcome in acute retinal necrosis. Br J Ophthalmol 1991;75:450–454.
21. Clarkson JG, Blumenkranz MS, Culbertson WW, et al. Retinal detachment following the acute retinal necrosis syndrome. Ophthalmology 1984;91:1665–1668.
22. Pepose JS, Van Gelder RN. Acute retinal necrosis syndrome. In: Ryan SJ, Glaser BM, editors. Retina. 3rd ed. v. 2. St. Louis: Mosby; 2001.
chap. 95.
23. Azad R, Ravi K, Talwar D, et al. Pars plana vitrectomy with or without silicone oil endotamponade in post traumatic endophthalmitis. Graefes Arch Clin Exp Ophthalmol 2003;241:478–483.
24. Min WK, Kang JH. Early Surgical Management in Bilateral Acute Retinal Necrosis. Korean J Ophthalmol 1990;4:46–49.