Retinal detachment after acute retinal necrosis: a retrospective analysis of hospitalized patients.

Purpose: To review hospitalized patients with Acute Retinal Necrosis (ARN) and investigate factors associated with subsequent retinal detachment (RD).

Study design: Retrospective.

Methods: The study included 40 patients (42 eyes), categorized into non-RD (23 eyes) and RD (19 eyes) groups. Patient demographics, ocular findings, treatment history, and visual outcomes were analyzed.

Results: The RD group had higher diabetes prevalence and worse initial and final visual acuity (VA) than the non-RD group (p = 0.035, p = 0.001, p = 0.000). The extent of retinal involvement was greater in the RD group (p = 0.000). The total steroid dose up to RD was significantly lower in the RD group (p = 0.023). Worse initial VA (p = 0.035) and greater retinal involvement (p = 0.036) increased the risk of RD. In the RD group, the time from initial symptoms to RD positively correlated with the duration of oral antivirals, the number of intravitreal antiviral injections, and the duration of oral steroids and immunosuppressants (p = 0.000, p = 0.023, p = 0.018, p = 0.001). The use of oral antivirals, steroids, and immunosuppressants was associated with longer median survival times compared to non-use (p = 0.000, p = 0.000, p = 0.048). The group receiving 9-11 intravitreal antiviral injections had a longer median survival time than the 0-4 and 5-8 injection groups (p = 0.009, p = 0.032).

Conclusions: In ARN, reduced steroid use due to diabetes may be associated with RD through inflammatory changes. The worse the initial VA and the greater the extent of retinal lesions, the higher the risk of RD. Oral antivirals, intravitreal antiviral injections, oral steroids, and oral immunosuppressants may be effective in delaying RD.