{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:33:57Z","timestamp":1777365237857,"version":"3.51.4"},"reference-count":48,"publisher":"Pensoft Publishers","issue":"6","license":[{"start":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T00:00:00Z","timestamp":1672444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>Acute retinal necrosis (ARN) is a devastating viral infection commonly associated with varicella zoster virus (VZV) and herpes simplex virus types 1 and 2 (HSV-1, HSV-2). Typically, ARN affects individuals without immune status disorders between the ages of 50-70. In two-thirds of the cases, one-eye involvement is observed and the inflammation can be presented as panuveitis. The most characteristic clinical manifestations are vitreitis, occlusion of the retinal arterioles, and peripheral necrotizing retinitis. Retinitis presents with the appearance of deep, multifocal, yellowish-white foci, typically localized in the peripheral retina. Systemic antivirals are the first treatment of choice for ARN. The goal of the therapy is to stop the viral replication and disease progression in the affected eye, as well as to prevent involvement of the healthy eye. The other eye can be attacked in an interval of 5 days to 30 years. The visual prognosis after illness is poor. Early diagnosis and timely initiation of treatment play an important role in maintaining visual acuity and preventing the other eye from being affected.<\/jats:p>","DOI":"10.3897\/folmed.64.e68036","type":"journal-article","created":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T10:00:06Z","timestamp":1672480806000},"page":"871-877","source":"Crossref","is-referenced-by-count":4,"title":["Acute retinal necrosis: pathophysiological aspects, diagnosis, and treatment"],"prefix":"10.3897","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5993-7143","authenticated-orcid":true,"given":"Vesela","family":"Mitkova-Hristova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina S.","family":"Stoyanova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2022,12,31]]},"reference":[{"key":"68036_B1","doi-asserted-by":"crossref","unstructured":"1. Schoenberger SD, Kim SJ, Thorne JE, et al. Diagnosis and treatment of acute retinal necrosis. Ophthalmology 2017; 124:382\u201392.","DOI":"10.1016\/j.ophtha.2016.11.007"},{"key":"68036_B2","doi-asserted-by":"crossref","unstructured":"2. Muthiah MN, Michaelides M, Child CS, et al. Acute retinal necrosis: a national population-based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the UK. Br J Ophthalmology 2007; 91:1452\u20135.","DOI":"10.1136\/bjo.2007.114884"},{"key":"68036_B3","doi-asserted-by":"crossref","unstructured":"3. Hillenkamp J, Nolle B, Bruns C, et al. Acute retinal necrosis: clinical features, early vitrectomy, and outcomes. Ophthalmology 2009; 116:1971\u20135.","DOI":"10.1016\/j.ophtha.2009.03.029"},{"key":"68036_B4","doi-asserted-by":"crossref","unstructured":"4. Lau CH, Missotten T, Salzmann J, et al. Acute retinal necrosis features, management, and outcomes. Ophthalmology 2007; 114:756\u201362.","DOI":"10.1016\/j.ophtha.2006.08.037"},{"key":"68036_B5","doi-asserted-by":"crossref","unstructured":"5. Ganatra JB, Chandler D, Santos C, et al. Viral causes of the acute retinal necrosis syndrome. Am J Ophthalmology 2000; 129:166\u201372.","DOI":"10.1016\/S0002-9394(99)00316-5"},{"key":"68036_B6","unstructured":"6. Bergstrom R, Tripathy K. Acute retinal necrosis. Stat Pearls (Internet) 2017. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470588\/"},{"key":"68036_B7","unstructured":"7. Lauren Taney, Murtaza Adam, Avrey Thau. Acute retinal necrosis. EyeWiki. Available from: https:\/\/eyewiki.aao.org\/Acute_retinal_necrosis"},{"key":"68036_B8","doi-asserted-by":"crossref","unstructured":"8. Whitcup SM. Acute retinal necrosis. In: Nussenblatt RB, Whitcup SM, eds. Uveitis fundamentals and clinical practice. 4th ed. Elsevier Inc 2010:176\u201382.","DOI":"10.1016\/B978-1-4377-0667-3.00017-5"},{"key":"68036_B9","unstructured":"9. Urayama A, Yamada N, Sasaki T. Unilateral acute uveitis with retinal periarteritis and detachment. Jpn J Clin Ophthalmol 1971; 25:607."},{"key":"68036_B10","doi-asserted-by":"crossref","unstructured":"10. Brown RM, Mendis U. Retinal arteritis complicating herpes zoster ophthalmicus. Br J Ophthalmology 1973; 57(5):344\u20136.","DOI":"10.1136\/bjo.57.5.344"},{"key":"68036_B11","doi-asserted-by":"crossref","unstructured":"11. Cibis GW. Neonatal herpes simplex retinitis. Albrecht Von Graefes Arch Klin Exp Ophthalmology 1975; 196(1):39\u201347.","DOI":"10.1007\/BF00410025"},{"key":"68036_B12","doi-asserted-by":"crossref","unstructured":"12. Young NJ, Bird AC. Bilateral acute retinal necrosis. Br J Ophthalmology 1978; 62(9):581\u201390.","DOI":"10.1136\/bjo.62.9.581"},{"key":"68036_B13","doi-asserted-by":"crossref","unstructured":"13. Culbertson WW, Blumenkranz MS, Haines H, et al. The acute retinal necrosis syndrome. Part 2: Histopathology and etiology. Ophthalmology 1982; 89(12):1317\u201325.","DOI":"10.1016\/S0161-6420(82)34638-2"},{"key":"68036_B14","doi-asserted-by":"crossref","unstructured":"14. Hayasaka S, Asano T, Yabata K, et al. Acute retinal necrosis. Br J Ophthalmology 1983; 67(7):455\u201360.","DOI":"10.1136\/bjo.67.7.455"},{"key":"68036_B15","unstructured":"15. Flaxel CJ, Yeh S, Lauer AK. Combination systemic and intravitreal antiviral therapy in the management of acute retinal necrosis syndrome (an American ophthalmological society thesis). Trans Am Ophthalmol Soc 2013; 111:133\u201344."},{"key":"68036_B16","doi-asserted-by":"crossref","unstructured":"16. Hedayatfar A, Khorasani M, Behnia M, et al. Seasonality of acute retinal necrosis. J Ophthalmic Vis Res 2020; 15(1):53\u20138.","DOI":"10.18502\/jovr.v15i1.5944"},{"key":"68036_B17","doi-asserted-by":"crossref","unstructured":"17. Holland GN. Standard diagnostic criteria for the acute retinal necrosis syndrome. Executive Committee of the American Uveitis Society. Am J Ophthalmol 1994; 117(5):663\u20137.","DOI":"10.1016\/S0002-9394(14)70075-3"},{"key":"68036_B18","doi-asserted-by":"crossref","unstructured":"18. Saari KM, Boke W, Manthey KF, et al. Bilateral acute retinal necrosis. Am J Ophthalmol 1982; 93:403\u201311.","DOI":"10.1016\/0002-9394(82)90128-3"},{"key":"68036_B19","doi-asserted-by":"crossref","unstructured":"19. Schlingemann RO, Bruinenberg M, Wertheim-van Dillen P, et al. Twenty years\u2019 delay of fellow eye involvement in herpes simplex virus type 2-associated bilateral acute retinal necrosis syndrome. Am J Ophthalmol 1996; 122:891\u20132.","DOI":"10.1016\/S0002-9394(14)70390-3"},{"key":"68036_B20","unstructured":"20. Patel S, Mukkamala L, Rescingo R, et al. Acute retinal necrosis: diagnosis, management, complications and outcomes of an 8 year retrospective case series. Insights in Ophthalmology 2017; 1(2):5."},{"key":"68036_B21","doi-asserted-by":"crossref","unstructured":"21. Lei B, Jiang R, Wang Zh, et al. Bilateral acute retinal necrosis: a case series. Retina 2020; 40(1):145\u201353.","DOI":"10.1097\/IAE.0000000000002341"},{"key":"68036_B22","doi-asserted-by":"crossref","unstructured":"22. Vandercam T, Hintzen RQ, de Boer JH, et al. Herpetic encephalitis is a risk factor for acute retinal necrosis. Neurology 2008; 71:1268\u201374.","DOI":"10.1212\/01.wnl.0000327615.99124.99"},{"key":"68036_B23","doi-asserted-by":"crossref","unstructured":"23. Maertzdorf J, Van der Lelij A, Baarsma GS, et al. Herpes simplex virus type 1 (HSV-1)-induced retinitis following herpes simplex encephalitis: indications for brain-to-eye transmission of HSV-1. Ann Neurol 2000; 48:936\u20139.","DOI":"10.1002\/1531-8249(200012)48:6<936::AID-ANA16>3.0.CO;2-7"},{"key":"68036_B24","doi-asserted-by":"crossref","unstructured":"24. Kianersi F, Masjedi A, Ghanbari H. Acute retinal necrosis after herpetic encephalitis. Case Rep Ophthalmol 2010; 1:85\u20139.","DOI":"10.1159\/000321708"},{"key":"68036_B25","doi-asserted-by":"crossref","unstructured":"25. Ye L, Ding X, Shen Sh, et al. Fulminant bilateral acute retinal necrosis complicated with secondary herpes simplex type-1 viral encephalitis. Medicine 2019; 98:35(e17001).","DOI":"10.1097\/MD.0000000000017001"},{"key":"68036_B26","unstructured":"26. Vann VR, Atherton SS. Neural spread of herpes simplex virus after anterior chamber inoculation. Investigat Ophthalmol Vis Sci 1991; 32:2462\u201372."},{"key":"68036_B27","doi-asserted-by":"crossref","unstructured":"27. Tripathy K, Sharma YR, Chawla R, et al. Triads in ophthalmology: a comprehensive review. Semin Ophthalmol 2017; 32(2):237\u201350.","DOI":"10.3109\/08820538.2015.1045150"},{"key":"68036_B28","doi-asserted-by":"crossref","unstructured":"28. Shanta J, Weissman H, Debiec M, et al. Advances in the management of acute retinal necrosis. Int Ophthalmol Clin 2015; 55(3):1\u201313.","DOI":"10.1097\/IIO.0000000000000077"},{"key":"68036_B29","doi-asserted-by":"crossref","unstructured":"29. Holland GN, Buhles WC Jr, Mastre B, et al. A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy. Use of a standardized system for the assessment of disease outcome. Arch Ophthalmol 1989; 107:1759\u201366.","DOI":"10.1001\/archopht.1989.01070020841024"},{"key":"68036_B30","doi-asserted-by":"crossref","unstructured":"30. Pendergast SD, Werner J, Drevon A, et al. Absence of herpesvirus DNA by polymerase chain reaction in ocular fluids obtained from immunocompetent patients. Retina 2000; 20:389\u201393.","DOI":"10.1097\/00006982-200004000-00012"},{"key":"68036_B31","doi-asserted-by":"crossref","unstructured":"31. Takase H, Okada AA, Goto H, et al. Development and validation of new diagnostic criteria for acute retinal necrosis. Jpn J Ophthalmol 2015; 59:14\u201320.","DOI":"10.1007\/s10384-014-0362-0"},{"key":"68036_B32","unstructured":"32. Kanski J, Bowling B. Kanski\u2019s Clinical Ophthalmology. ISBN: 978-0-7020-5572-0; 8th ed. 2016; 11: 440-442."},{"key":"68036_B33","doi-asserted-by":"crossref","unstructured":"33. Ghannam MY, Naseemuddin M, Weiser P, et al. Acute multifocal hemorrhagic retinal vasculitis in a child: a case report. BMC Ophthalmology 2016; 16:181.","DOI":"10.1186\/s12886-016-0360-8"},{"key":"68036_B34","doi-asserted-by":"crossref","unstructured":"34. Winterhalter S, Stuebiger N, Maier AK, et al. Acute retinal necrosis: diagnostic and treatment strategies in Germany. Ocul Immunol Inflamm 2016: 24(5):537\u201343.","DOI":"10.3109\/09273948.2015.1034375"},{"key":"68036_B35","doi-asserted-by":"crossref","unstructured":"35. Palay DA, Sternberg P Jr, Davis J, et al. Decrease in the risk of bilateral acute retinal necrosis by acyclovir therapy. Am J Ophthalmol 1991; 112(3):250\u20135.","DOI":"10.1016\/S0002-9394(14)76725-X"},{"key":"68036_B36","doi-asserted-by":"crossref","unstructured":"36. Jeon S, Kakizaki H, Lee WK, et al. Effect of prolonged oral acyclovir treatment in acute retinal necrosis. Ocul Immunol Inflam 2012; 20(4):288\u201392.","DOI":"10.3109\/09273948.2012.689073"},{"key":"68036_B37","doi-asserted-by":"crossref","unstructured":"37. Powell B, Wang D, Llop S, et al. Management strategies of acute retinal necrosis: current perspectives. Clinical Ophthalmology 2020; 14:1931\u201343.","DOI":"10.2147\/OPTH.S258488"},{"key":"68036_B38","doi-asserted-by":"crossref","unstructured":"38. De Miranda P, Blum MR. Pharmacokinetics of acyclovir after intravenous and oral administration. J Antimicrob Chemother 1983; (12 B):29\u201337.","DOI":"10.1093\/jac\/12.suppl_B.29"},{"key":"68036_B39","doi-asserted-by":"crossref","unstructured":"39. Tam PM, Hooper CY, Lightman S. Antiviral selection in the management of acute retinal necrosis. Clinical Ophthalmology 2010; 4:11\u201320.","DOI":"10.2147\/OPTH.S6390"},{"key":"68036_B40","doi-asserted-by":"crossref","unstructured":"40. Sawyer MH, Webb DE, Balow JE, et al. Acyclovir-induced renal failure. Clinical course and histology. Am J Med 1988; 84:1067\u201371.","DOI":"10.1016\/0002-9343(88)90313-0"},{"key":"68036_B41","doi-asserted-by":"crossref","unstructured":"41. Keeney RE, Kirk LE, Bridgen D. Acyclovir tolerance in humans. Am J Med 1982; 73:176\u201381.","DOI":"10.1016\/0002-9343(82)90086-9"},{"key":"68036_B42","doi-asserted-by":"crossref","unstructured":"42. Soul-Lawton J, Seaber E, On N, et al. Absolute bioavailability and metabolic disposition of valaciclovir, the L-valyl ester of acyclovir, following oral administration to humans. Antimicrob Agents Chemother 1995; 39:2759\u201364.","DOI":"10.1128\/AAC.39.12.2759"},{"key":"68036_B43","doi-asserted-by":"crossref","unstructured":"43. Almeida DR, Chin EK, Tarantola RM, et al. Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis. Clin Ophthalmol 2015; 9:1307\u201314.","DOI":"10.2147\/OPTH.S87644"},{"key":"68036_B44","doi-asserted-by":"crossref","unstructured":"44. Baltinas J, Lightman S, Tomkins-Netzer O. Comparing treatment of acute retinal necrosis with either oral valacyclovir or intravenous acyclovir. Am J Ophthalmol 2018; 188:173\u201380.","DOI":"10.1016\/j.ajo.2018.02.001"},{"key":"68036_B45","doi-asserted-by":"crossref","unstructured":"45. Wong R, Pavesio CE, Laidlaw DA, et al. Acute retinal necrosis: the effects of intravitreal foscarnet and virus type on outcome. Ophthalmology 2010; 117(3):556\u201360.","DOI":"10.1016\/j.ophtha.2009.08.003"},{"key":"68036_B46","doi-asserted-by":"crossref","unstructured":"46. Tibbetts MD, Shah CP, Young LH, et al. Treatment of acute retinal necrosis. Ophthalmology 2010; 117(4): 818\u201324.","DOI":"10.1016\/j.ophtha.2009.09.001"},{"key":"68036_B47","doi-asserted-by":"crossref","unstructured":"47. Risseeuw S, H de Boer J, Dam-van Loon N, et al. Risk of rhegmatogenous retinal detachment in acute retinal necrosis with and without prophylactic intervention. Am J Ophthalmol 2019; 206:140\u20138.","DOI":"10.1016\/j.ajo.2019.05.023"},{"key":"68036_B48","unstructured":"48. Tripathy K, Chawla R, Venkatesh P, et al. Ultrawide field imaging in uveitic non-dilating pupils. J Ophthalmic Vis Res 2017; 12(2):232\u20133."}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/68036\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/68036\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=68036&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T16:07:48Z","timestamp":1673021268000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/68036\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,31]]},"references-count":48,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,12,31]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.64.e68036","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12,31]]}}}