Acute Retinal Necrosis: Diagnostic and Treatment Strategies in Germany

Winterhalter, Sibylle; Stuebiger, Nicole; Maier, Anna-Karina B.; Pleyer, Uwe; Heiligenhaus, Arnd; Mackensen, Friederike; Zierhut, Manfred; Joussen, Antonia M.; Neß, Thomas

doi:10.3109/09273948.2015.1034375

Cited by 25 publications

(14 citation statements)

References 18 publications

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“… 46 , 47 Data from a British registry reported an incidence of 0.5–0.63 patients/year of ARN, a number that remained fairly stable over the last decade and has been recently confirmed in a German survey. 48 , 49 There is a consistent finding that relates the subtype of virus with patient’s age. VZV is more likely to be found in middle-aged and older patients, whereas HSV-1 and HSV-2 are the predominant cause in young adults and children.…”

Section: Herpes Virus-associated Posterior Uveitismentioning

confidence: 80%

“…The causative agents are VZV, HSV-1, HSV-2, and rarely, CMV or Epstein–Barr virus 46,47. Data from a British registry reported an incidence of 0.5–0.63 patients/year of ARN, a number that remained fairly stable over the last decade and has been recently confirmed in a German survey 48,49. There is a consistent finding that relates the subtype of virus with patient’s age.…”

Section: Herpes Virus-associated Posterior Uveitismentioning

confidence: 84%

“…A recent survey among German uveitis centers report that oral antiviral treatment was continued for 6 months in 27% of respondents, followed by 3 months (24%), and was even extended over 12 months in 18% of respondents. 49 …”

Section: Herpes Virus-associated Posterior Uveitismentioning

confidence: 99%

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Current aspects on the management of viral uveitis in immunocompetent individuals

Pleyer

Chee

2015

OPTH

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Viruses are a fundamental etiology of ocular inflammation, which may affect all structures of the organ. Advances in molecular diagnostics reveal an increasingly broader spectrum of virus-associated intraocular inflammation, including all members of the herpes family, rubella virus, and other more rare causes such as Epstein–Barr and chikungunya virus. In particular, viruses of the herpes family are important causes of anterior and posterior uveitis. Owing to their often fulminant clinical course and persistence in ocular tissues, a clear differential diagnosis between alpha- and beta-type herpes viruses is essential to guide acute and long-term treatment. Here, we review the epidemiology, clinical, and laboratory findings of virus-associated uveitis with emphasis on their therapy and management and include our own experience.

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Section: Herpes Virus-associated Posterior Uveitismentioning

confidence: 80%

Section: Herpes Virus-associated Posterior Uveitismentioning

confidence: 84%

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Current aspects on the management of viral uveitis in immunocompetent individuals

Pleyer

Chee

2015

OPTH

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“…The treatment of viral posterior uveitis 263,270 includes systemic antivirals given orally or intravenously, intravitreal antivirals or intraocular antiviral implants, and topical and systemic corticosteroids. 40 Management of complications is also important to ensure a favorable prognosis.…”

Section: Viral Posterior Uveitismentioning

confidence: 99%

Viral posterior uveitis

Lee

Agarwal

Mahendradas

et al. 2017

Survey of Ophthalmology

111

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The causes of posterior uveitis can be divided into infectious, autoimmune, or masquerade syndromes. Viral infections, a significant cause of sight-threatening ocular diseases in the posterior segment, include human herpesviruses, measles, rubella, and arboviruses such as dengue, West Nile, and chikungunya virus. Viral posterior uveitis may occur as an isolated ocular disease in congenital or acquired infections or as part of a systemic viral illness. Many viruses remain latent in the infected host with a risk of reactivation that depends on various factors, including virulence and host immunity, age, and comorbidities. Although some viral illnesses are self-limiting and have a good visual prognosis, others, such as cytomegalovirus retinitis or acute retinal necrosis, may result in serious complications and profound vision loss. Since some of these infections may respond well to antiviral therapy, it is important to work up all cases of posterior uveitis to rule out an infectious etiology. We review the clinical features, diagnostic tools, treatment regimens, and long-term outcomes for each of these viral posterior uveitides.

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“…The German Ophthalmologic Society distributed a questionnaire on ARN therapy to 35 eye hospitals in Germany [49]. Based on the data compiled from the responding hospitals, all institutes commenced therapy with aciclovir, followed by ganciclovir, foscarnet and, in some cases, brivudine.…”

Section: Hsv1 Hsv2 Vzv and CMVmentioning

confidence: 99%

A new era of uveitis: impact of polymerase chain reaction in intraocular inflammatory diseases

et al. 2016

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Uveitis is a sight-threatening intraocular inflammatory disorder which may occur from both infectious and non-infectious or autoimmune causes. The frequency of infectious uveitis and autoimmune uveitis varies depending on countries and regions. According to a nationwide survey conducted by the Japanese Ocular Inflammation Society, infectious and non-infectious uveitis accounted for 16.4 and 50.1% of new patients, respectively while the remaining 33.5% of new uveitis cases were not classified or were idiopathic uveitis. Infectious uveitis is particularly important because it causes tissue damage to the eye and may result in blindness unless treated. However, it can be treated if the pathogenic microorganisms are identified promptly and accurately. Remarkable advancements in molecular and immunological technologies have been made in the last decade, and the diagnosis of infectious uveitis has been greatly improved by the application of molecular and immunological investigations, particularly polymerase chain reaction (PCR). PCR performed on a small amount of ocular samples provides a prompt, sensitive, and specific molecular diagnosis of pathogenic microorganisms in the eye. This technology has opened a new era in the diagnosis and treatment of uveitis, enabling physicians to establish new clinical entities of uveitis caused by infectious microorganisms, identify pathogens in the eyes of many patients with uveitis, and determine prompt diagnosis and appropriate therapy. Here we review the PCR process, new PCR tests specialized for ocular diseases, microorganisms detected by the PCR tests, diseases in the eye caused by these microorganisms, and the clinical characteristics, diagnosis, and therapy of uveitis.

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Acute Retinal Necrosis: Diagnostic and Treatment Strategies in Germany

Abstract: Relevant variations were seen in diagnosis and treatment practices. The survey outlines the need for a unique diagnostic and therapeutic guideline.

Cited by 25 publications

References 18 publications

Current aspects on the management of viral uveitis in immunocompetent individuals

Current aspects on the management of viral uveitis in immunocompetent individuals

Viral posterior uveitis

A new era of uveitis: impact of polymerase chain reaction in intraocular inflammatory diseases

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