Download PDF
Klin Monbl Augenheilkd 2007; 224(7): 567-574
DOI: 10.1055/s-2007-963182
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Akute Retinanekrose

Acute Retinal NecrosisS. Winterhalter1 , O. Adams2 , Ch Althaus3 , J. Stammen1 , E. M. Schöler1 , A. M. Joussen1
  • 1Augenklinik, Universitätsklinikum Düsseldorf
  • 2Institut für Virologie, Universitätsklinikum Düsseldorf
  • 3Augenklinik, Ahaus
Further Information

Publication History

Eingegangen: 2.4.2007

Angenommen: 5.3.2007

Publication Date:
26 July 2007 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die akute Retinanekrose (ARN) ist ein seltenes Krankheitsbild, das durch Herpesviren ausgelöst wird. Immunsupprimierter Status und durch die akute Retinanekrose ausgelöste Komplikationen führen in vielen Fällen zu einem schlechten visuellen Endergebnis. Eine frühe Diagnosestellung durch Polymerasekettenreaktion und Antikörperbestimmungen aus Vorderkammer- und Glaskörperpunktat wird daher empfohlen. Hierdurch kann einerseits das therapeutische Management verbessert sowie andererseits eine Krankheitsprogression mit erhöhtem Komplikationsrisiko vermindert werden. Gute Therapieerfolge sind durch antivirale Kombinationstherapien mit Aciclovir, Foscarnet und Ganciclovir in systemischer und intravitrealer Form möglich. Literatur-Empfehlungen und eigene Erfahrungen werden dargestellt.

Abstract

Acute retinal necrosis (ARN) is a rare entity caused by Herpes viruses. An immunocompromised background and the complications of ARN mostly lead to a poor visual outcome. Confirmation of the early diagnosis through polymerase chain reaction and antibody detection from aqueous or vitreous taps is recommended to improve the medical management and prevent disease progression with an increased risk of complications. Favourable outcomes are possible by means of combined antiviral systemic and intravitreal strategies with Acyclovir, Foscarnet and Ganciclovir. We report on the relevant literature recommendations and our own experience.

Schlüsselwörter

akute Retinanekrose - Polymerasekettenreaktion - Goldmann-Witmer-Koeffizient - antivirale Therapie - intravitreale Injektion - Vitrektomie

Key words

acute retinal necrosis - polymerase chain reaction - Goldman-Witmer coefficient - antiviral therapy - intravitreal injection - vitrectomy

Literatur

  • 1 Urayama A, Yamada N, Sasaki T. Unilateral acute uveitis with periarteritis and detachment.  Jpn J Clin Ophthalmol. 1971;  25 607-619
    PubMedGoogle Scholar
  • 2 Culbertson W W, Blumenkranz M S, Haines H, Gass J DM. et al . The acute retinal necrosis syndrome part 2. Histopathology and etiology.  Ophthalmology. 1982;  89 1317
    PubMedGoogle Scholar
  • 3 Forster D J, Dugel P U, Frangieh G T, Liggett P E. et al . Rapidley progressive outer retinal necrosis in the acquired immunodeficiency syndrome.  Am J Ophthalmol. 1990;  110 341-348
    PubMedGoogle Scholar
  • 4 Kychenthal A, Coombes A, Greenwood J, Pavesio C. et al . Bilateral acute retinal necrosis and herpes simplex type 2 encephalitis in a neonate.  BJ Ophthalmology. 2001;  85 (5) 629-630
    PubMedGoogle Scholar
  • 5 Van Gelder R N, Willig J L, Holland G N, Kaplan H J. Herpes Simplex Virus Tye 2 as a Cause of Acute Retinal Necrosis Syndrome in Young Patients.  Ophthalmology. 2001;  108 869-876
    CrossrefPubMedGoogle Scholar
  • 6 Ganatra J B, Chandler D, Santos C, Kuppermann B. et al . Viral Causes of the Acute Retinal Necrosis Syndrome.  Am J Ophthalmol. 2000;  129 (2) 166-172
    CrossrefPubMedGoogle Scholar
  • 7 Tran T H, Stanescu D, Caspers-Velu L, Rozenberg F. et al . Clinical Characteristics of Acute HSV-2 Retinal Necrosis.  Am J Ophthalmol. 2003;  137 (5) 872-879
    PubMedGoogle Scholar
  • 8 Bergua A, Schmidt B, Küchle M. Foudroyante akute nekrotisierende Retinitis 10 Monate nach ipsilateraler Herpes-simplex-Virus-Enzephalitis - eine Kasuistik.  Klin Monatsbl Augenheilkd. 2001;  218 737-740
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Fabricius E M, Lipp T H, Kaboth W. Akute Retinanekrose und Herpes-Enzephalitis.  Klin Monatsbl Augenheilkd. 1990;  196 160-165
    PubMedGoogle Scholar
  • 10 Rahhal F M, Siegel L M, Russak V, Wiley C A. et al . Clinicopathologic Correlations in Acute Retinal Necrosis Caused by Herpes Simplex Virus Type 2.  Arch Ophthalmol. 1996;  114 1416-1419
    PubMedGoogle Scholar
  • 11 Holland GN and the Executive Committee of the American Uveitis Society . Standard Diagnostic Criteria for the Acute Retinal Necrosis Syndrome.  Am J Ophthalmol. 1994;  117 (5) 663-667
    PubMedGoogle Scholar
  • 12 Engstrom R E, Holland G N, Margolis T P, Muccioli C. et al . The Progressive Outer Retinal Necrosis Syndrome. A Variant of Necrotizing Herpetic Retinopathy in Patients with Aids.  Ophthalmology. 1994;  101 1488-1502
    PubMedGoogle Scholar
  • 13 Pepose J S, Flowers B, Stewart J A, Grose C h. et al . Herpesvirus Antibody Levels in the Etiologic Diagnosis of the Acute Retinal Necrosis Syndrome.  Am J Ophthalmol. 1992;  113 248-256
    PubMedGoogle Scholar
  • 14 Tran T H, Bodaghi B, Rozenberg F, Cassoux N. et al . Prise en charge diagnostique et therapeutique des rétinites nécrosantes herpétiques.  JFr Ophtalmol. 2004;  27 (3) 223-236
    PubMedGoogle Scholar
  • 15 Moshfeghi D M, Dodds E M, Couto C A, Santos C I. et al . Diagnostic approaches to severe, atypical toxoplasmosis mimicking acute retinal necrosis.  Ophthalmology. 2004;  111 (4) 716-725
    CrossrefPubMedGoogle Scholar
  • 16 Balansard B, Bodaghi B, Cassoux N, Fardeau C. et al . Necrotising retinopathies simulating acute retinal necrosis syndrome.  BJ Ophthalmology. 2005;  89 96-101
    PubMedGoogle Scholar
  • 17 Zierhut M. Uveitis. Band 1: Differentialdiagnose Kohlhammer 2000 2ed
    Google Scholar
  • 18 Kanski J J. Klinische Ophthalmologie. München - Jena; Urban und Fischer 2003 5ed
    Google Scholar
  • 19 Schmidt D, Berghorn C, Wiek J, Dichmann S. et al . Augenbefunde bei Syphilis.  Klin Monatsbl Augenheilkd. 2002;  219 433-439
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Zierhut M, Baatz H, Coupland S, Deuter C. et al . Die Uveitis des alternden Menschen.  Ophthalmologe. 2006;  103 765-772
    CrossrefPubMedGoogle Scholar
  • 21 Krause L. Morbus Adamantiades-Behcet.  Ophthalmologe. 2005;  102 329-334
    CrossrefPubMedGoogle Scholar
  • 22 Coupland S E, Heimann H. Primäres intraokulares Lymphom.  Ophthalmologe. 2004;  101 (2) 87-98
    CrossrefPubMedGoogle Scholar
  • 23 Boer J H, Layendijk de L, Rothova A, Baarsma G S. et al . Detection of Intraocular Antibody Production to Herpesviruses in Acute Retinal Necrosis Syndrome.  Am J Ophthalmol. 1994;  117 201-210
    PubMedGoogle Scholar
  • 24 Knox C M, Chandler D, Short G A, Margolis T P. Polymerase Chain Reaction-based Assays of Vitreous Samples for the Diagnosis of Viral Retinitis. Use in Diagnostic Dilemmas.  Ophthalmology. 1998;  105 (1) 37-44
    CrossrefPubMedGoogle Scholar
  • 25 Boer J H, Verhagen C, Bruinenberg M, Rothova A. et al . Serologic and Polymerase Chain Reaction Analysis of Intraocular Fluids in the Diagnosis of Infectious Uveitis.  Am J Ophthalmol. 1996;  121 650-658
    PubMedGoogle Scholar
  • 26 Doornenbal P, Baarsma S, Quint W, Kijlstra A. et al . Diagnostic assays in cytomegalovirus retinitis: detection of herpesvirus by simultaneous application of the polymerase chain reaction and local antibody analysis on ocular fluid.  BrJ Ophthalmol. 1996;  80 235-240
    PubMedGoogle Scholar
  • 27 Abe T, Tsuchida K, Tamai M. A comparative study of the polymerase chain reaction and local antibody production in acute retinal necrosis syndrome and cytomegalovirus retinitis.  Graefe’s Arch Clin Exp Ophthalmol. 1996;  234 419-424
    PubMedGoogle Scholar
  • 28 Lobo A, Lightman S. Viteous aspiration needle tap in the diagnosis of intraocular inflammation.  Ophthalmology. 2003;  110 (3) 595-599
    CrossrefPubMedGoogle Scholar
  • 29 Palay D, Sternberg P, Davis J, Lewis H. et al . Decrease in the Risk of Bilateral Acute Retinal Necrosis by Acyclovir Therapy.  Ophthalmology. 1991;  112 250-255
    CrossrefPubMedGoogle Scholar
  • 30 Martinez J, Lambert M, Capone A, Sternberg P. et al . Delayed Bilateral Involvement in the Acute Retinal Necrosis Syndrome.  Am J Ophthalmol. 1992;  113 (1) 103-104
    PubMedGoogle Scholar
  • 31 Blumenkranz M S, Culbertson W W, Clarkson J G. Treatment of the acute retinal necrosis syndrome with intravenous Acyclovir.  Ophthalmology. 1986;  93 (3) 1317-1325
    PubMedGoogle Scholar
  • 32 Field H F. Herpes simplex virus antiviral drug resistance-current trends and future prospects.  J ClinVirol. 2001;  21 261-269
    PubMedGoogle Scholar
  • 33 Morel C, Metge F, Roman S, Scheer S. et al . Nécrose rétinienne aigue: présentation clinique, modalités de prise en charge et pronostic à partir d’une série de 22 patients.  JFr Ophtalmol. 2004;  27 (1) 7-13
    PubMedGoogle Scholar
  • 34 Bodaghi B, Mougin C, Michelson S, Agut H. et al . Acyclovir-resistant bilateral keratitis associated with mutations.  Exp Eye Res. 2000;  71 353-359
    CrossrefPubMedGoogle Scholar
  • 35 Oueghlani E, Baglivo E, Durakovic O, Safran A B. Varicella-Zoster Virus Retinitis: Successful Evolution with a Combination of Antiviral Therapies.  Klin Monatsbl Augenheilkd. 2005;  222 264-266
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Sarant V. Oral valganciclovir treatment of varicella zoster virus acute retinal necrosis.  Eye. 2004;  18 544-545
    CrossrefPubMedGoogle Scholar
  • 37 Emerson G G, Smith J R, Wilson D J, Rosenbaum J T. et al . Primary Treatment of Acute Retinal Necrosis with Oral Antiviral Therapy.  Ophthalmology. 2006;  113 (12) 2259-2261
    CrossrefPubMedGoogle Scholar
  • 38 Savant V, Saeed T, Denniston A, Murray P I. Oral valganciclovir treatment of varicella zoster virus acute retinal necrosis.  Eye. 2004;  18 544-545
    CrossrefPubMedGoogle Scholar
  • 39 Pérez-Blázquez E, Traspas R, Méndez Marín I, Montero M. et al . Treatment in Progressive Outer Retinal Necrosis.  Am J Ophthalmol. 1997;  124 (3) 418-421
    PubMedGoogle Scholar
  • 40 Lee M, Cooney E, Stoessel K, Gariano R. Varicella Zoster Virus Retrobulbar Optic Neuritis Preceding Retinitis in Patients with Acquired Immune Deficiency Syndrome.  Ophthalmology. 1997;  105 (3) 467-471
    PubMedGoogle Scholar
  • 41 Luu K, Scott J, Chaudhry N, Verm A. et al . Intravitreal Antiviral Injections as Adjunctive Therapy in the Management of Immunocompetent Patients With Necrotizing Herpetic Retinopathy.  Am J Ophthalmol. 2000;  129 (6) 811-813
    CrossrefPubMedGoogle Scholar
  • 42 Scott I U, Luu K M, Davis J L. Intravitreal Antivirals in the Management of Patients With Aquired Immunodeficiency Syndrome With Progressive Outer Retinal Necrosis.  Arch Ophthalmol. 2002;  120 1219-1222
    PubMedGoogle Scholar
  • 43 Velez G, Roy Ch, Whitcup S, Chan C C. et al . High-Dose Intravitreal Ganciclovir and Foscarnet for Cytomegalovirus Retinitis.  Am J Ophthalmol. 2001;  131 396-397
    CrossrefPubMedGoogle Scholar
  • 44 Morlet N, Young S, Naidoo D, Graham G. et al . High dose intrvitreal ganciclovir injection provides a prolonged therapeutic intraocular concentration.  BrJ Ophthalmol. 1996;  80 214-216
    PubMedGoogle Scholar
  • 45 Moorthy R S, Weinberg D V, Teich S A, Berger B B. et al . Management of varicella zoster virus retinitis in AIDS.  BJ Ophthalmology. 1997;  81 189-194
    PubMedGoogle Scholar
  • 46 Ando F, Kato M, Goto S, Kobayashi K. et al . Platelet function in bilateral acute retinal necrosis.  Am J Ophthalmol. 1983;  96 27-32
    PubMedGoogle Scholar
  • 47 Hudde T, Althaus Ch, Sundmacher R. Akutes Retinanekrose (ARN)-Syndrom.  Der Ophthalmologe. 1998;  95 473-477
    CrossrefPubMedGoogle Scholar
  • 48 Culbertson W W, Atherton S S. Acute retinal necrosis and similar retinitis syndromes.  Int Ophthalmol Clin. 1993;  33 129-143
    PubMedGoogle Scholar
  • 49 Cooper H M, Beer P M. Spontaneous Regression and Successful Laser Prophylaxis in Progressive Outer Retinal Necrosis Syndrome.  Am J Ophthalmol. 1996;  121 (6) 723-724
    PubMedGoogle Scholar
  • 50 Stoffelns B, Pfeiffer N. Akute Retinanekrose: Silikonöltamponade bei Netzhautablösungen.  Ophthalmologe. 1997;  94 568-572
    CrossrefPubMedGoogle Scholar
  • 51 Weinberg D V, Lyon A T. Repair of Retinal Detachments Due to herpes Varicella-Zoster Virus Retinitis in Patients with Acquired Immune Deficienfy Syndrome.  Ophthalmology. 1997;  104 279-282
    PubMedGoogle Scholar

Dr. S. Winterhalter

Augenklinik, Universitätsklinikum Düsseldorf

Moorenstr. 5

40225 Düsseldorf

Phone: ++49/2 11/8 11 73 20

Fax: ++49/2 11/8 11 95 57

Email: billewin@gmx.de

      >