Choice of opportune moment for acute retinal necrosis syndrome by vitrectomy

Objective To analyze visual outcome in acute retinal necrosis syndrome(ARNs) by vitrectomy at different opportune moment.Methods A retrospective study was carried out in 5 hospitalized patients(7 eyes) with acute retinal necrosis syndrome during the period of september,2009 to Octobe,2011,The age ranged from 47 to 63 years old with average 55.2 ± 6.5.Two cases(2 eyes) with retinal detachment confirmed preoperative received vitrectomy combined with lens extraction and silicone oil tamponade.Ocular symptoms of 3 cases(3 eyes) were aggravated during antiviral therapy.Prophylactic vitrectomy were performed on 2 cases(2 eyes) without retinal detachment,while silicone oil tamponade were performed on another cases(1 eye) which retinal detachment was found during vitrectomy.Two cases(2 eyes) attacked sequentially were treated with antiviral therapy and laser photocoagulation.Results The follow-up period ranged from 6 to 24 months.Three eyes with silicone oil tamponade underwent silicone oil removal at a approximate interval of 6 months,whose visual acuity had no improvement,and recurrent retinal detachment developed in 1 eye.Retina attached in 2 eyes received prophylactic vitrectomy and 2 eyes attacked sequentially,which visual outcome was better than before treatment.Conclusion Timely prophylactic vitrectomy was effective in preventing the development of retinal detachment and was associated with better recovery of visual function in eyes with ARNs,which antiviral therapy was invalid.