Prophylactic vitrectomy for acute retinal necrosis

Abstract

Prophylactic vitrectomy is effective in preventing the development of RRD in eyes where necrotic lesions do not extend beyond the midperiphery (zone 2).

Emerging concepts in the management of acute retinal necrosis

“…The benefit of early surgical intervention to prevent retinal detachment is controversial. Some authors believe that early vitrectomy with antiviral lavage lowers the risk or retinal detachment,79 whereas others have found no advantage to early vitrectomy 80. In some cases, despite anatomic success, final visual function may be limited—particularly when the infection has involved the optic nerve and/or macula 74 79…”

Infections of the Posterior Segment: Acute Retinal Necrosis

“…Recently, some investigators have advocated for early vitrectomy surgery in ARN patients before the appearance of a retinal detachment. Ishida et al [ 42 ] reviewed the outcomes of patients with ARN who underwent a prophylactic vitrectomy; the surgery was not helpful in preventing detachments in eyes with posterior pole involvement. However, the rate of retinal detachment was lower in patients with mid-peripheral involvement that received the prophylactic surgery.…”

Acute retinal necrosis in a monocular patient complicated by acyclovir-induced nephrotoxicity

“…Finally, prophylactic retinal laser as well as vitrectomy have been advocated to prevent rhegmatogenous retinal detachment: a serious, late complication of ARN that may occur despite maximized pharmacologic therapy. 10,22 Clinical case resolution On day 3, his antiviral treatment was modified to renally dosed ganciclovir given his acyclovir-induced nephropathy. Qualitative PCR from the anterior chamber paracentesis returned positive for HSV-2 on the second day of admission (HSV-1, VZV, CMV and EBV were negative).…”