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Long‐term visual prognosis in necrotising herpetic retinitis
Author(s) -
COSTANTINI E,
DUCOS DE LAHITTE G,
TRAN T,
CASSOUX N,
FARDEAU C,
TERRADA C,
AKNIN C,
ROZENBERG F,
LEHOANG P,
BODAGHI B
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.463.x
Subject(s) - medicine , visual acuity , ganciclovir , retinitis , ophthalmology , antiviral therapy , retinal detachment , surgery , retinal , virus , virology , human cytomegalovirus , chronic hepatitis
Purpose To determine the long‐term ocular complications and visual outcome in patients with necrotising herpetic retinitis (NHR). Methods 26 patients (33 eyes) with NRH diagnosed between June 1987 and January 2002 at Pitie‐Salpetriere Hospital, in Paris, France, were retrospectively reviewed. Demographic data, clinical presentation, viral identification (when possible), initial therapeutic management, long‐term antiviral therapy, complications and final visual acuity were analyzed. Results 16 patients (61.5%) were male, 10 (38.5%) were female. Age ranged from 11 to 67 years (mean 40.6 years). All patients were treated with intensive intravenous antiviral therapy, 9 (34.6%) with additional intravitreous ganciclovir injections. At last examination, 20 patients (76.9%) were still under prophylactic antiviral treatment. Complications were cataract (63.6%), retinal detachment (48.5%), recurrence (33.3%), macular edema (36.4%), optic atrophy (30.3%) and epimacular membrane (27.3%). Final visual acuity was below 20/200 in 15 eyes (45.5%). The minimal follow‐up was 3 years. Conclusion Despite aggressive antiviral therapy, visual prognosis remains guarded in patients with NHR. Retinal vasculopathy and optic disc alterations are major factors to consider in order to improve the visual outcome.