{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:28:00Z","timestamp":1787218080017,"version":"build-2736575974"},"reference-count":24,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,1,30]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To quantify nationwide incidence and contemporary treatment patterns of acute retinal necrosis (ARN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort using Japan\u2019s National Database of Health Insurance Claims and Specific Health Checkups, which covers &gt;95% of claims. New-onset ARN (2016\u20132022) was identified by ARN diagnostic codes plus antiviral therapy. Annual, age-specific and sex-specific incidence rates used governmental denominators; age-standardised rates used the WHO world standard. Surgical management (vitreoretinal surgery, silicone oil (SO)\/perfluorocarbon (PFC) use, glaucoma surgery) was assessed up to 2 years after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 586 incident cases (313 men, 273\u2009women), crude incidence was 0.066 (95% CI 0.061 to 0.072) per 100\u2009000 person-years; the age-standardised rate was 0.040 per 100\u2009000 person-years. Incidence rose with age, peaking at 70\u201374 years, and was consistently higher in men than in women. Vitreoretinal surgery occurred in 42.4% by 30 days and 59.4% by 365 days after diagnosis; 25.1% underwent \u22652 procedures within 1 year. SO or PFC was used in 40.8% by 1 year. Glaucoma surgery was uncommon (&lt;2% by 2 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the largest population-based study of ARN to date, nationwide incidence in Japan closely matched prior UK estimates, suggesting cross-system consistency in ARN epidemiology. Management was characterised by early, intensive surgery with frequent tamponade use and substantial reoperation, informing clinical triage and resource planning for this rare, vision-threatening condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-328609","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:20:14Z","timestamp":1770942014000},"page":"1064-1069","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and treatment patterns of acute retinal necrosis: a nationwide population-based cohort study"],"prefix":"10.1136","volume":"110","author":[{"given":"Masahiro","family":"Akada","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 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