Acute retinal necrosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{SI}} | {{SI}} | ||
{{CMG}}; {{AE}} {{Faizan}} | {{CMG}}; {{AE}} {{Faizan}} | ||
==Overview== | ==Overview== | ||
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One study indicated an incidence of 1 per 1.6 to 2.0 million.<ref name="pmid17504853">{{cite journal |author=Muthiah MN, Michaelides M, Child CS, Mitchell SM |title=Acute retinal necrosis: a national population‐based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK |journal=Br J Ophthalmol |volume=91 |issue=11 |pages=1452–5 |year=2007 |pmid=17504853 |doi=10.1136/bjo.2007.114884 |url=http://bjo.bmj.com/cgi/pmidlookup?view=long&pmid=17504853 |pmc=2095441}}</ref> | One study indicated an incidence of 1 per 1.6 to 2.0 million.<ref name="pmid17504853">{{cite journal |author=Muthiah MN, Michaelides M, Child CS, Mitchell SM |title=Acute retinal necrosis: a national population‐based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK |journal=Br J Ophthalmol |volume=91 |issue=11 |pages=1452–5 |year=2007 |pmid=17504853 |doi=10.1136/bjo.2007.114884 |url=http://bjo.bmj.com/cgi/pmidlookup?view=long&pmid=17504853 |pmc=2095441}}</ref> | ||
==Historical Perspective== | |||
==Classification== | |||
==Pathophysiology== | |||
==Causes== | ==Causes== | ||
The exact causes are not known, but [[varicella zoster virus]] is frequently implicated,<ref name="pmid17184841">{{cite journal |author=Lau CH, Missotten T, Salzmann J, Lightman SL |title=Acute retinal necrosis features, management, and outcomes |journal=Ophthalmology |volume=114 |issue=4 |pages=756–62 |year=2007 |pmid=17184841 |doi=10.1016/j.ophtha.2006.08.037 |url=http://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)01207-3}}</ref> and other [[herpesviridae|herpesviruses]] can be involved.<ref name="pmid17264500">{{cite journal |author=Kezuka T, Atherton SS |title=Acute retinal necrosis |journal=Chem Immunol Allergy |volume=92 |issue= |pages=244–53 |year=2007 |pmid=17264500 |doi=10.1159/000099275 |url=http://content.karger.com/produktedb/produkte.asp?doi=10.1159/000099275&typ=pdf |series=Chemical Immunology and Allergy |isbn=3-8055-8187-4}}</ref> | The exact causes are not known, but [[varicella zoster virus]] is frequently implicated,<ref name="pmid17184841">{{cite journal |author=Lau CH, Missotten T, Salzmann J, Lightman SL |title=Acute retinal necrosis features, management, and outcomes |journal=Ophthalmology |volume=114 |issue=4 |pages=756–62 |year=2007 |pmid=17184841 |doi=10.1016/j.ophtha.2006.08.037 |url=http://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)01207-3}}</ref> and other [[herpesviridae|herpesviruses]] can be involved.<ref name="pmid17264500">{{cite journal |author=Kezuka T, Atherton SS |title=Acute retinal necrosis |journal=Chem Immunol Allergy |volume=92 |issue= |pages=244–53 |year=2007 |pmid=17264500 |doi=10.1159/000099275 |url=http://content.karger.com/produktedb/produkte.asp?doi=10.1159/000099275&typ=pdf |series=Chemical Immunology and Allergy |isbn=3-8055-8187-4}}</ref> | ||
==Differentiating {{PAGENAME}} from Other Diseases== | |||
==Epidemiology and Demographics== | |||
==Risk Factors== | |||
==Screening== | |||
==Natural History, Complications, and Prognosis== | |||
===Natural History=== | |||
===Complications=== | |||
===Prognosis=== | |||
==Diagnosis== | |||
===Diagnostic Criteria=== | |||
===History and Symptoms=== | |||
===Physical Examination=== | |||
===Laboratory Findings=== | |||
===Imaging Findings=== | |||
===Other Diagnostic Studies=== | |||
==Treatment== | ==Treatment== | ||
===Medical Therapy=== | |||
:*''' Empiric antimicrobial therapy''' | :*''' Empiric antimicrobial therapy''' | ||
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::*''' Cytomegalovirus''' | ::*''' Cytomegalovirus''' | ||
:::*Preferred regimen: [[Foscarnet]] 1.2-2.4 mg/0.1 mL intravitreal injection 1-3 times per week {{and}} [[Ganciclovir]] 5 mg/kg IV q12 for 2 weeks followed by 5 mg/kg q24h for 5-7 weeks followed by [[Valganciclovir]] 900 mg PO qd for chronic maintenance | :::*Preferred regimen: [[Foscarnet]] 1.2-2.4 mg/0.1 mL intravitreal injection 1-3 times per week {{and}} [[Ganciclovir]] 5 mg/kg IV q12 for 2 weeks followed by 5 mg/kg q24h for 5-7 weeks followed by [[Valganciclovir]] 900 mg PO qd for chronic maintenance | ||
===Surgery=== | |||
===Prevention=== | |||
==See also== | ==See also== | ||
* [[Cytomegalovirus retinitis]] | * [[Cytomegalovirus retinitis]] | ||
* [[Progressive outer retinal necrosis]] | * [[Progressive outer retinal necrosis]] | ||
==External links== | ==External links== | ||
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* http://www.eyepathologist.org/disease.asp?IDNUM=301330 | * http://www.eyepathologist.org/disease.asp?IDNUM=301330 | ||
==References== | |||
[[Category: | {{reflist|2}} | ||
[[Category:Ophthalmology]] | |||
Revision as of 15:40, 3 August 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]
Overview
Acute retinal necrosis is a type of retinitis which can be associated with viral infections.
It was first characterized in 1971.[1][2]
One study indicated an incidence of 1 per 1.6 to 2.0 million.[3]
Historical Perspective
Classification
Pathophysiology
Causes
The exact causes are not known, but varicella zoster virus is frequently implicated,[4] and other herpesviruses can be involved.[5]
Differentiating Acute retinal necrosis from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
- Empiric antimicrobial therapy
- Alternative regimen (1): Acyclovir 10 mg/kg IV q8h for 1-2 weeks followed by Valacyclovir 1 g IV q8h for 6 weeks to several months followed by Acyclovir 400 mg PO bid for chronic maintenance
- Alternative regimen (2), unresponsive: Foscarnet 1.2-2.4 mg/0.1 mL intravitreal injection 1-3 times per week AND (Ganciclovir 5 mg/kg IV q12 for 2 weeks followed by 5 mg/kg q24h for 5-7 weeks OR Foscarnet 60 mg/kg IV q8h for 2 weeks followed by 90-120 mg/kg IV q24h OR Cidofovir 5 mg/kg IV for 2 weeks followed by 5 mg/kg IV q2weeks) followed by (Acyclovir 400 mg PO bid for chronic maintenance OR Valganciclovir 900 mg PO qd for chronic maintenance)
- Note: Ganciclovir is administered for patients with suspected CMV acute retinal necrosis. Whereas Foscarnet is administered for patients who are not immunocompromised
- Pathogen-directed antimicrobial therapy
- HSV or VZV
- Preferred regimen: Acyclovir 10 mg/kg IV q8h for 1-2 weeks followed by Acyclovir 400 mg PO bid for chronic maintenance
- Alternative regimen: Acyclovir 10 mg/kg IV q8h for 1-2 weeks followed by Valacyclovir 1 g IV q8h for 6 weeks to several months followed by Acyclovir 400 mg PO bid for chronic maintenance
- Cytomegalovirus
- Preferred regimen: Foscarnet 1.2-2.4 mg/0.1 mL intravitreal injection 1-3 times per week AND Ganciclovir 5 mg/kg IV q12 for 2 weeks followed by 5 mg/kg q24h for 5-7 weeks followed by Valganciclovir 900 mg PO qd for chronic maintenance
Surgery
Prevention
See also
External links
- http://www.iceh.org.uk/files/tsno8/text/18.htm
- http://www.eyepathologist.org/disease.asp?IDNUM=301330
References
- ↑ "eMedicine - Acute Retinal Necrosis : Article by Andrew A Dahl, MD". Archived from the original on 16 February 2008. Retrieved 2008-02-05.
- ↑ Urayama A, Yamada N, Sasaki T: Unilateral acute uveitis with retinal periarteritis and detachment. Jpn J Clin Ophthalmol 1971; 25: 607.
- ↑ Muthiah MN, Michaelides M, Child CS, Mitchell SM (2007). "Acute retinal necrosis: a national population‐based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK". Br J Ophthalmol. 91 (11): 1452–5. doi:10.1136/bjo.2007.114884. PMC 2095441. PMID 17504853.
- ↑ Lau CH, Missotten T, Salzmann J, Lightman SL (2007). "Acute retinal necrosis features, management, and outcomes". Ophthalmology. 114 (4): 756–62. doi:10.1016/j.ophtha.2006.08.037. PMID 17184841.
- ↑ Kezuka T, Atherton SS (2007). "Acute retinal necrosis". Chem Immunol Allergy. Chemical Immunology and Allergy. 92: 244–53. doi:10.1159/000099275. ISBN 3-8055-8187-4. PMID 17264500.