T. Hudde et al., ARGON-LASER PHOTOCOAGULATION TO PREVENT RHEGMATOGENOUS RETINAL-DETACHMENT IN PATIENTS WITH ACUTE RETINAL NECROSIS (ARN) SYNDROME, Der Ophthalmologe, 95(7), 1998, pp. 473-477
Background: ARN syndrome follows severe intraocular infection by herpe
s viruses and primarily affects the peripheral retina. Following scar
formation, despite antiviral treatment, rhegmatogenous retinal detachm
ent occurs very often. Prophylactic argon laser photocoagulation has t
herefore been proposed. We report our experience. Patients: We treated
five patients presenting clinically with advanced unilateral ARN with
acyclovir. All eyes received a prophylactic confluent double row of a
rgon laser treatment (500 mu m, 0.2 s, gray-white lesions) central to
the affected area as soon as was possible, depending on the vitreous c
louding. Four patients were treated with Aspirin. Results: One of the
five patients had a peripheral rhegmatogenous retinal detachment that
was limited by the argon laser row. Another patient had a tractional d
etachment needing vitreoretinal surgery. Two eyes developed vitreal he
morrhage of unknown origin. Conclusion: A lower rate of rhegmatogenous
retinal detachments than expected occurred post-laser treatment. Vitr
eal hemorrhage was more frequent than previously reported. The bleedin
g probably originated from anterior retinal neovascularization and may
have been enhanced by Aspirin treatment. We recommend early prophylac
tic argon laser photocoagulation in all ARN patients in agreement with
the results of previous studies.