Acute retinal necrosis secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
While recurrence of acute retinal necrosis is not presently completely preventable, the administration of topical and intravitreal antiviral therapy targeted to the specific cause of the disease can reduce the chance of recurrence.
Secondary Prevention
While recurrence of acute retinal necrosis is not presently completely preventable, the administration of topical and intravitreal antiviral therapy targeted to the specific cause of the disease can reduce the chance of recurrence.[1]
- Application of antiviral therapy is more effective for prevention when administered as close to disease onset as possible.
- Extensive, prolonged therapy is important for preventing the disease from spreading to the unaffected eye.
Further prophylactic measures, such as vitrectomy, may be used in current acute retinal necrosis patients to minimize the possibility of complications, including retinal detachment.[2]
Prophylactic laser retinopexy may be indicated to prevent retinal detachment by photocoagulation, creating posterior chorioretinal adhesions.[3][4]
- The procedure is contraindicated if there is vitreous inflammation or obstructed view and access to the posterior pole.
Due to reported occurrences of retinal detachment from prophylactic laser photocoagulation, more research is necessary to determine the ideal indications for the procedure.[3]
- If performed on patients with excessive inflammation and vitreous opacity, there is evidence of photocoagulation worsening prognosis of acute retinal necrosis, leading to retinal detachment and blindness.[5]
References
- ↑ Flaxel CJ, Yeh S, Lauer AK (2013). "Combination systemic and intravitreal antiviral therapy in the management of acute retinal necrosis syndrome (an American Ophthalmological Society thesis)". Trans Am Ophthalmol Soc. 111: 133–44. PMC 3868412. PMID 24385671.
- ↑ Shantha JG, Weissman HM, Debiec MR, Albini TA, Yeh S (2015). "Advances in the management of acute retinal necrosis". Int Ophthalmol Clin. 55 (3): 1–13. doi:10.1097/IIO.0000000000000077. PMC 4567584. PMID 26035758.
- ↑ 3.0 3.1 Park JJ, Pavesio C (2008). "Prophylactic laser photocoagulation for acute retinal necrosis. Does it raise more questions than answers?". Br J Ophthalmol. 92 (9): 1161–2. doi:10.1136/bjo.2008.147181. PMID 18723739.
- ↑ Chun HL, Missotten T, Salzmann J, Lightman SL (2007). "Acute Retinal Necrosis: Features, Management, and Outcomes". Opthalmology. 114: 756–762. Unknown parameter
|Issue=ignored (|issue=suggested) (help) - ↑ Kawaguchi T, Spencer DB, Mochizuki M (2008). "Therapy for acute retinal necrosis". Semin Ophthalmol. 23 (4): 285–90. doi:10.1080/08820530802111192. PMID 18584565.