Advances in the diagnosis and management of acute retinal necrosis  

作　　者：Casey L.Anthony J.Clay Bavinger Steven Yeh 

机构地区：[1]Department of Ophthalmology,Emory Eye Center,Atlanta,GA,USA

出　　处：《Annals of Eye Science》2020年第3期69-76,共8页眼科学年鉴（英文）

基　　金：This project was supported by the National Eye Institute/National Institutes of Health core grant P30-EY06360(Department of Ophthalmology,Emory University School of Medicine);National Eye Institute of the National Institutes of Health under award RO1 EY029594(SY);The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the views or policies of the Department of Health and Human Services,nor does mention of trade names,commercial products,or organizations imply endorsement by the U.S.Government;This research was also supported an unrestricted departmental grant from Research to Prevent Blindness,Inc.to the Emory Eye Center,Emory University School of Medicine and Association for Research in Vision and Ophthalmology Mallinckrodt Young Investigator Award(SY).

摘　　要：Acute retinal necrosis(ARN)is a devastating syndrome characterized by panuveitis,retinal necrosis,and a high rate of retinal detachment that may result in poor visual outcomes if not promptly diagnosed and treated.ARN is most commonly caused by viruses within the herpesvirus family.Etiologies include varicella-zoster virus,herpes simplex virus,and cytomegalovirus,and may be promptly diagnosed by polymerase chain reaction testing of aqueous or vitreous fluid.The true incidence of ARN is not known due to its rarity;as a result,clinical treatment is often guided by retrospective case series,case reports,and expert opinion.Standard of care has evolved over time but currently includes a combination of systemic and intravitreal antiviral in conjunction with topical or oral steroids and surgical therapy as needed.Combination therapy may reduce the rate of severe vision loss and increase the rate of visual acuity gain,although further studies are needed in this area.In particular for patients with mild to moderate disease,combination therapy may reduce the rate of retinal detachment.Adjunctive therapies including oral corticosteroid and prophylactic laser barricade are incompletely studied,but corticosteroid in particular,may reduce inflammation,which also is involved in the severe disease pathogenesis observed in ARN.This review discusses the advances in diagnosis and treatment of ARN,including management with combination antiviral medication and surgical interventions.

关 键 词：Acute retinal necrosis(ARN) herpetic retinitis HERPESVIRUS retinal detachment 

分 类 号：R73[医药卫生—肿瘤]