ARGON-LASER PHOTOCOAGULATION TO PREVENT RHEGMATOGENOUS RETINAL-DETACHMENT IN PATIENTS WITH ACUTE RETINAL NECROSIS (ARN) SYNDROME

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.