Acute Retinal Necrosis - Current Perspectives

Acute retinal necrosis (ARN) is a rare infectious viral uveitis syndrome that may result in visually devastating consequences if not diagnosed and treated timely. The most common etiology involved is varicella zoster virus followed by herpes simplex virus. Over past several decades, initial treatment regimens have shifted from intravenous antivirals requiring hospital admission to oral antivirals with intravitreal antivirals for immediate local control. The true incidence of ARN is not known. Polymerase chain reaction testing from aqueous sample provides a rapid and sensitive method of identifying the viral etiology but one should not delay treatment while awaiting PCR results. Due to its rarity and lack of large-scale prospective research trials, still debate continues over recommended practice guidelines for an ideal treatment protocol. Further studies are needed to refine disease protocols and improve outcomes for this challenging infectious disease.