Prophylactic Laser Photocoagulation and Vitrectomy for Acute Retinal Necrosis

NCT02222857 | Completed

• 1 other identifier: 201406118RIND
• Study Type: observational
• Target: 23
• Locations: 1 country
• Sites: 1

Brief Summary

Acute retinal necrosis (ARN) is a rare infectious retinitis which can potentially lead to devastating visual outcomes. ARN is diagnosed on the basis of the clinical appearance and disease course according to the diagnostic criteria proposed by the American Uveitis Society: (1) one or more foci of retinal necrosis with discrete borders in the peripheral retina; (2) rapid progression in the absence of antiviral therapy; (3) circumferential spread; (4) occlusive vasculopathy with arteriolar involvement; and (5) a prominent inflammatory reaction in the vitreous and anterior chambers. Herpesvirus infection, especially varicella-zoster virus (VZV) and herpes simplex virus (HSV), was presumed to be the pathogenic agent in the pathogenesis of ARN. Medical treatment with systemic antiviral agent had been the base of the therapy of ARN for decades and such treatment usually result in regression of retinitis. However, the visual outcome of ARN remains poor. The major causes of poor visual prognosis in ARN are retinal detachment and optic nerve or macular involvement by ischemic vasculopathy. Less frequent causes include macular hole formation, macular pucker, or hypotony. Rhegmatogenous retinal detachment may occur in 75 % of the untreated eyes. It may occur weeks to months after the onset of inflammation due to delayed formation of retinal breaks, which result from the combination of necrotic retina and vitreoretinal traction. Therefore, application of argon laser retinopexy prophylactically posterior to necrotic retina or prophylactic vitrectomy to reduce inflammatory factors and the vitreoretinal traction had been used to protect the healthy area from detachment. However, the results were varied and there is no consensus on the efficacy and indications of those prophylactic procedures. We had applied the prophylactic procedure in our treatment for ARN. We aim to access the efficacy of the treatment strategy of ARN and the correlated factors to the outcomes.

Conditions

Acute Retinal Necrosis; Retinal Detachment; Laser Photocoagulation; Vitrectomy

Keywords

Acute retinal necrosis; Retinal detachment; Laser photocoagulation; Vitrectomy

Outcome Measures

Primary Outcomes (1)

• Best-corrected visual acuity

  Best-corrected visual acuity during follow up and its correlated factors

  1 year

Secondary Outcomes (1)

• Retinal status

  1 year

Eligibility Criteria

• Age: 20 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with acute retinal necrosis

You may qualify if:

• ●Patients with clinical diagnosis of acute retinal necrosis.

You may not qualify if:

• Patients with history of retinal detachment.
• Patients with history of other causes of severe retinal atrophy or necrosis.
• HIV positive patients.

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

National Taiwan University Hospital

Taipei, 100, Taiwan

Location

MeSH Terms

Conditions

Retinal Necrosis Syndrome, Acute; Retinal Detachment

Condition Hierarchy (Ancestors)

Retinitis; Retinal Diseases; Eye Diseases

Study Officials

• Chang-Ping Lin, MD

  National Taiwan University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 20, 2014
• First Posted: August 21, 2014
• Study Start: August 1, 2014
• Primary Completion: August 1, 2014
• Study Completion: August 1, 2014
• Last Updated: April 26, 2018

Record last verified: 2014-08

Locations

TW (1)