Pattern of Acute Retinal Necrosis in a Referral Center in Tunisia, North Africa
Purpose
To describe the pattern of acute retinal necrosis (ARN) in a referral center in Tunisia, North Africa.
Methods
The charts of 22 patients diagnosed with ARN from January 2006 to January 2023, in the Department of Ophthalmology, Fattouma Bourguiba Hospital of Monastir, were retrospectively reviewed.
Results
The mean age at presentation was 39.2 (range, 12-70) years, sex ratio was 1.75. The mean diagnostic delay was 17.9 days (range, 1-60). The mean visual acuity at presentation was 20/400. All patients presented with mild to moderate anterior uveitis (100%) with granulomatous keratic precipitates in 18 eyes (81%) and ocular hypertension in 4 eyes (18%). Necrotizing retinitis involved more than 50% of the retina in 36.5% of eyes. Polymerase chain reaction on aqueous humor sample identified varicella zoster virus (VZV) in 10 eyes (45%), herpes simplex virus-1 (HSV-1) in 4 eyes (18%) and was negative in 8 eyes (36%). All patients received intravenous acyclovir, followed by oral antivirals. Intravitreal injections of ganciclovir were administered in 12 eyes (54.5%). Follow up ranged from 6 months to 48 months. The mean final visual acuity was 20/200. Complications included retinal detachment (RD) (31,8%), macular edema (18%), macular atrophy (22%), epimacular membrane (22%), cataract (27%), optic nerve atrophy (18%), and central retinal artery occlusion (4%). No patient developed bilateral ARN. Prophylactic laser was performed in 7 eyes (32%). RD was treated with pars plana vitrectomy and silicone oil injection in 7 eyes.
Conclusion
ARN syndrome in Tunisia is most commonly caused by VZV followed by HSV-1. An earlier diagnosis and management are mandatory for a better visual prognosis.
Conflict of interest
No
Authors 1
Last name
NABI
Initials of first name(s)
W
Department
Department of Ophthalmology, Fattouma Bourguiba Hospital of Monastir, Tunisia
City
Monastir
Country
Tunisia
Authors 2
Last name
Mahjoub
Initials of first name(s)
A
Department
Department of Ophthalmology, Fattouma Bourguiba Hospital of Monastir, Tunisia
City
Monastir
Country
Tunisia
Authors 3
Last name
Trimech
Initials of first name(s)
I
Department
Department of Ophthalmology, Fattouma Bourguiba Hospital of Monastir, Tunisia
City
Monastir
Country
Tunisia
Authors 4
Last name
Kechida
Initials of first name(s)
M
Department
Department of internal medecine, Fattouma Bourguiba Hospital of Monastir
City
Monastir
Country
Tunisia
Authors 5
Last name
Jelliti
Initials of first name(s)
B
Department
Department of Ophthalmology, Fattouma Bourguiba Hospital of Monastir, Tunisia
City
Monastir
Country
Tunisia
Authors 6
Last name
Khairallah
Initials of first name(s)
M
Department
Department of Ophthalmology, Fattouma Bourguiba Hospital of Monastir, Tunisia
City
Monastir
Country
Tunisia
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