Our Summary

This research paper discusses the case of a 4-year-old girl who had a recurring eye condition known as acute retinal necrosis (ARN), which can damage the retina, the part of the eye that processes light. Despite initial treatment, the girl’s condition relapsed several times and was difficult to control. She also suffered a detached retina, a serious condition where the retina separates from the back of the eye, in her left eye.

The doctors tried different treatments, including laser treatment and medication (acyclovir, foscarnet, and valacyclovir) to control the disease. The treatments were successful, and she was free of the disease for 10 years while on medication. However, when she stopped taking her medication during a trip to South America, the disease came back.

After her return, she was given antiviral treatment and the doctors managed to treat a new retinal detachment. Despite her previous health issues, her eyesight was perfect (20/20) six years later, while she continued to take antiviral medication.

The study concludes that ARN can be treated effectively with aggressive treatment. It also suggests that scars on the retina, like those from laser treatment, could potentially be areas where the virus causing ARN can re-enter. As a result, patients at risk of ARN might need to take antiviral medication to prevent the disease from coming back.

FAQs

  1. What is the recommended treatment for recurrent acute retinal necrosis (ARN)?
  2. Can retinal detachment be a complication of ARN and how is it treated?
  3. What is the role of antiviral prophylaxis in managing ARN?

Doctor’s Tip

A helpful tip a doctor might give to a patient undergoing retinal surgery is to follow all post-operative instructions carefully, including taking any prescribed medications as directed, attending follow-up appointments, and avoiding activities that could potentially harm the healing eye. It is also important to communicate any changes in vision or symptoms to the doctor immediately. Following these guidelines can help ensure the best possible outcome for the surgery and recovery process.

Suitable For

Patients who are typically recommended retinal surgery include those with severe retinal detachment, macular holes, diabetic retinopathy, retinal tears, and other retinal disorders that cannot be treated effectively with other methods such as medication or laser therapy. In the case described above, the patient with recurrent acute retinal necrosis (ARN) underwent retinal surgery for a retinal detachment that developed despite initial treatment with antiviral medications. Additionally, the patient required laser photocoagulation to treat the retinal necrosis and vasculitis associated with ARN. Retinal surgery may be recommended for patients with similar conditions who do not respond to conservative treatment methods.

Timeline

  • Patient initially presents with bilateral acute retinal necrosis (ARN) at 4 years old
  • Patient undergoes treatment for ARN but develops retinal detachment in left eye, requiring vitrectomy surgery
  • 10 years later, patient presents with recurrent ARN and is treated with intravenous acyclovir and foscarnet
  • Patient undergoes laser photocoagulation and is placed on oral valacyclovir prophylaxis
  • Patient remains disease-free for 10 years but stops valacyclovir before traveling to South America and experiences recurrence of ARN
  • Patient flies back for treatment and responds to antiviral treatment but develops retinal detachment
  • Patient undergoes successful treatment for retinal detachment and achieves visual acuity of 20/20 six years later with antiviral prophylaxis

What to Ask Your Doctor

  1. What is the success rate of retinal surgery for my specific condition?
  2. What are the potential risks and complications associated with retinal surgery?
  3. How long is the recovery process and what can I expect in terms of visual improvement?
  4. Will I need any additional treatments or medications after the surgery?
  5. How often will I need follow-up appointments to monitor my condition?
  6. Are there any lifestyle changes or precautions I should take after the surgery to prevent recurrence?
  7. What is the likelihood of recurrence of ARN in my case and what can be done to prevent it?
  8. Will I need to continue taking antiviral medication as prophylaxis after the surgery?
  9. Are there any specific signs or symptoms I should watch out for that may indicate a recurrence of ARN?
  10. Are there any support groups or resources available for patients with ARN that I can access for further information and support?

Reference

Authors: Spaide RF, Byun SS. Journal: Retin Cases Brief Rep. 2022 Nov 1;16(6):667-669. doi: 10.1097/ICB.0000000000001107. PMID: 33346624