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TitleClinical and Virological Characteristics and Prognostic Factors in Viral Necrotizing Retinitis
PurposeTo describe the clinical and virological characteristics of viral necrotizing retinitis and assess the factors predicting the occurrence of retinal detachment or poor visual outcome(ie.best corrected visual acuity ≥0.7logMAR at 1month of surgery).
MethodsRetrospective study of all consecutive VNR patients diagnosed and monitored by qPCR on aqueous humor between 2015 and 2019.All patients received≥1intravenous antiviral therapy followed by oral antivirals+/-intravitreal injections of antiviral agents.
Results41 of 37patients of mean age 56years were included.Involved viruses were VZV(44%),CMV(37%)and HSV2 (19%).ARN represented 51%,PORN 12% and CMV retinitis 37% of included eyes.46 percent of patients were immunocompromised.Mean BCVA was 0.98 logMar at baseline and 1.05 logMar after an average of 14.1 months [range: 1-39].VNR bilateralized in 34% of cases after an average of 32 months [range: 0-96].RD occurred in 27% of cases after an average of 98 days [range: 0-330].Factors associated with poor visual outcome were: advanced age, low baseline BCVA, high grade of baseline vitritis, high baseline viral load and a "slow responder" status (ie.VL decrease<50% after 2 +/-1 weeks of IV antivirals).Factors associated with RD occurrence were:advanced age, immunocompetent status, low baseline BCVA, high baseline vitritis, and the use of > 5 IVIs.
ConclusionVNR is a sight-threatening condition whose outcomes depend on various clinical factors including advanced age, immunocompetence, low BCVA and higher vitritis grade at baseline. New virological factors were found predictive of a poor visual prognosis:high baseline VL and the “slow responder” status.
Conflict of interestNo
Authors 1
Last nameFITOUSSI
Initials of first name(s)L
Department75
CityParis
CountryFrance
Authors 2
Last nameTOUHAMI
Initials of first name(s)S
Department75
CityParis
CountryFrance
Authors 3
Last nameBODAGHI
Initials of first name(s)B
Department75
CityParis
CountryFrance