Systemic antivirals alone appropriate for acute retinal necrosis
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CHICAGO — Adjunctive treatment did not reduce the rate of retinal detachment in acute retinal necrosis more than the gold standard treatment of systemic antivirals alone, according to a study presented here.
At the American Academy of Ophthalmology meeting, Ines Lains, MD, PhD, said acute retinal necrosis (ARN) is a rare viral infection that leads to high rates of retinal detachment.
“Currently, the standard treatment of ARN is with systemic antivirals,” she said. “However, these patients frequently have poor outcomes, so clinicians add adjunctive treatments in an effort to improve these outcomes.”
The adjunctive treatments come in the form of intravitreal injection of antivirals and prophylactic pars plana vitrectomy (PPV).
Lains and colleagues conducted a retrospective, cross-sectional analysis of the IRIS Registry to determine the association between initial treatment regimen and the occurrence of retinal detachment in patients with ARN from 2016 to 2020. Five hundred thirty-three eyes of 457 patients met the inclusion criteria, including 358 eyes that received systemic antivirals alone, 155 eyes that received systemic and intravitreal antivirals, and 20 eyes that underwent PPV in addition to receiving systemic/intravitreal antivirals.
There was no difference in rates of retinal detachment across the three groups at either 6 months or 12 months, with rates hovering around 20% at both time points in all groups. Additionally, the time to retinal detachment was similar across all groups.
“This supports that the current gold standard treatment for ARN, systemic antivirals alone, is appropriate and is associated with similar rates of retinal detachment,” Lains said. “We hope that this can contribute to guide the management of this rare and blinding disease.”
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Lains I, et al. Initial treatment regimen and incidence of retinal detachment in acute retinal necrosis: An IRIS Registry study. Presented at: American Academy of Ophthalmology meeting; Sept. 30-Oct. 3, 2022; Chicago.
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