{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:28:52Z","timestamp":1786739332232,"version":"build-2736575974"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe the clinical profile of a large cohort of patients with acute retinal necrosis (ARN) in a tertiary eyecare institute from India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective analysis of all patients with ARN, visiting the uveitis clinic of a tertiary eye institute between 2010 and 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result:<\/jats:title>\n                    <jats:p>The study included 144 eyes of 119 patients with ARN (mean age 37.6 \u00b1 15.8 years); 68.6% were males. A history of chickenpox was present in 12.6% and viral encephalitis in 9.2%. The common presenting symptom was blurred vision (94.9%), followed by redness (28.8%), pain (24.6%), and floaters (15.3%). Misdiagnosis occurred in 36.9% of cases. At presentation, 79.0% had unilateral disease, while 21.0% were bilateral, with many showing sequential involvement after a mean interval of 5.9 years. Anterior uveitis was documented in 30.5% of eyes, vitritis grade \u2265 II in 70.8%, and all four quadrants of retinitis in 47.8%. Retinal vasculitis and optic nerve involvement were noted in 84.0% and 39.6%, respectively. Polymerase chain reaction detected herpes simplex virus and varicella-zoster virus with equal frequency (28.6% each); dual infection was found in 5.0%. Most patients received intravenous acyclovir induction followed by oral antivirals, with valacyclovir used in 80.7%. The mean treatment duration was 5 months. Follow-up averaged 2 years, during which the visual acuity declined from 1.58 to 1.89 logMAR. Major complications included cataract (79.2%), retinal detachment (72.5%), hypotony (48.6%), and optic atrophy (25%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ARN remains a devastating viral retinitis which is frequently underrecognized in its early stages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2415_25","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T05:00:14Z","timestamp":1779858014000},"page":"856-861","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Acute retinal necrosis: Report 1\u2014Epidemiology, clinical profile, and misdiagnosis from the largest Indian case series"],"prefix":"10.4103","volume":"74","author":[{"given":"Swati","family":"Priyadarshini","sequence":"first","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parthopratim","family":"Dutta Majumder","sequence":"additional","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshee","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitra","family":"Pradeep","sequence":"additional","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amala Elizabeth","family":"George","sequence":"additional","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinita","family":"Rao","sequence":"additional","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotirmay","family":"Biswas","sequence":"additional","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha K","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"R1-20260527","doi-asserted-by":"crossref","first-page":"28","DOI":"10.21037\/aes-2019-dmu-09","article-title":"Advances in the diagnosis and management of acute retinal necrosis","volume":"5","author":"Anthony","year":"2020","journal-title":"Ann Eye Sci"},{"key":"R2-20260527","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/S0002-9394(99)00316-5","article-title":"Viral causes of the acute retinal necrosis syndrome","volume":"129","author":"Ganatra","year":"2000","journal-title":"Am J Ophthalmol"},{"key":"R3-20260527","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/00006982-198909030-00002","article-title":"Visual results and complications after retinal reattachment in the acute retinal necrosis syndrome. The influence of operative technique","volume":"9","author":"Blumenkranz","year":"1989","journal-title":"Retina"},{"key":"R4-20260527","doi-asserted-by":"crossref","first-page":"635","DOI":"10.4103\/ijo.IJO_1353_20","article-title":"Outcomes of 25-gauge pars plana vitrectomy with encircling scleral band for acute retinal necrosis-related rhegmatogenous retinal detachment","volume":"69","author":"Moharana","year":"2021","journal-title":"Indian J Ophthalmol"},{"issue":"Suppl 1","key":"R5-20260527","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.4103\/IJO.IJO_2168_24","article-title":"Clinical features and management of eyes with acute retinal necrosis presenting with rhegmatogenous retinal detachment","volume":"73","author":"Gore","year":"2025","journal-title":"Indian J Ophthalmol"},{"key":"R6-20260527","doi-asserted-by":"crossref","first-page":"277","DOI":"10.4103\/tjo.TJO-D-25-00012","article-title":"Clinical features and outcomes of rhegmatogenous retinal detachments in acute retinal necrosis","volume":"15","author":"Nasir","year":"2025","journal-title":"Taiwan J Ophthalmol"},{"key":"R7-20260527","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3109\/09273948.2013.819928","article-title":"Acute retinal necrosis: Clinical features, management and outcomes--A 10 year consecutive case series","volume":"22","author":"Roy","year":"2014","journal-title":"Ocul Immunol Inflamm"},{"key":"R8-20260527","doi-asserted-by":"crossref","first-page":"858","DOI":"10.4103\/IJO.IJO_1585_24","article-title":"Clinical profile and treatment outcomes in acute retinal necrosis in a South Indian patient population","volume":"73","author":"Mooss","year":"2025","journal-title":"Indian J Ophthalmol"},{"key":"R9-20260527","doi-asserted-by":"crossref","first-page":"1468801","DOI":"10.3389\/fmed.2024.1468801","article-title":"Atypical presentation of acute retinal necrosis mimicking Vogt-Koyanagi-Harada disease leading to misdiagnosis: A case report","volume":"11","author":"Zhu","year":"2024","journal-title":"Front Med"},{"key":"R10-20260527","doi-asserted-by":"crossref","first-page":"e258437","DOI":"10.1136\/bcr-2023-258437","article-title":"Unilateral acute retinal necrosis in a young Indian male patient","volume":"18","author":"Mahajan","year":"2025","journal-title":"BMJ Case Rep"},{"key":"R11-20260527","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1080\/09273948.2021.1938135","article-title":"Acute retinal necrosis as a presenting ophthalmic manifestation in COVID 19 recovered patients","volume":"29","author":"Soni","year":"2021","journal-title":"Ocul Immunol Inflamm"},{"key":"R12-20260527","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1080\/09273948.2024.2444512","article-title":"An unusual case of exudative retinal detachment in a 6-year-old child with acute retinal necrosis","volume":"33","author":"Kene","year":"2025","journal-title":"Ocul Immunol Inflamm"},{"key":"R13-20260527","first-page":"370","article-title":"Acute retinal necrosis in the United Kingdom: Results of a prospective surveillance study","volume":"26","author":"Cochrane","year":"2012","journal-title":"Eye Lond Engl"},{"key":"R14-20260527","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1212\/01.wnl.0000327615.99124.99","article-title":"Herpetic encephalitis is a risk factor for acute retinal necrosis","volume":"71","author":"Vandercam","year":"2008","journal-title":"Neurology"},{"key":"R15-20260527","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jcv.2016.04.021","article-title":"Delayed recurrence of acute retinal necrosis (ARN): A case series","volume":"80","author":"Donovan","year":"2016","journal-title":"J Clin Virol"},{"key":"R16-20260527","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.3390\/jcm9041204","article-title":"Viral loads in ocular fluids of acute retinal necrosis eyes infected by varicella-zoster virus treated with intravenous acyclovir treatment","volume":"9","author":"Sato","year":"2020","journal-title":"J Clin Med"},{"key":"R17-20260527","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12348-023-00366-x","article-title":"False negative result of polymerase chain reaction in very early stages of acute retinal necrosis","volume":"13","author":"Wang","year":"2023","journal-title":"J Ophthalmic Inflamm Infect"},{"key":"R18-20260527","doi-asserted-by":"crossref","first-page":"100636","DOI":"10.1016\/j.ajoc.2020.100636","article-title":"Bilateral acute retinal necrosis caused by two separate viral etiologies","volume":"18","author":"Williams","year":"2020","journal-title":"Am J Ophthalmol Case Rep"},{"key":"R19-20260527","doi-asserted-by":"crossref","first-page":"1000151","DOI":"10.4172\/2324-8599.1000151","article-title":"Acute retinal necrosis with multiple viral infections: A case report","volume":"3","author":"Chen","year":"2014","journal-title":"Int J Ophthalmic Pathol"},{"key":"R20-20260527","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1186\/s12886-021-02096-x","article-title":"Acute retinal necrosis caused by co-infection with multiple viruses in a natalizumab-treated patient: A case report and brief review of literature","volume":"21","author":"Cheraqpour","year":"2021","journal-title":"BMC Ophthalmol"},{"key":"R21-20260527","first-page":"e47599","article-title":"Co-infection of cytomegalovirus and Epstein-Barr virus in an immunocompetent patient: A case series and literature review","volume":"15","author":"AlAmeen","journal-title":"Cureus"},{"key":"R22-20260527","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/S0161-6420(86)33740-0","article-title":"Treatment of the acute retinal necrosis syndrome with intravenous acyclovir","volume":"93","author":"Blumenkranz","year":"1986","journal-title":"Ophthalmology"},{"key":"R23-20260527","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S0002-9394(14)76725-X","article-title":"Decrease in the risk of bilateral acute retinal necrosis by acyclovir therapy","volume":"112","author":"Palay","year":"1991","journal-title":"Am J Ophthalmol"},{"key":"R24-20260527","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ajo.2018.02.001","article-title":"Comparing treatment of acute retinal necrosis with either oral valacyclovir or intravenous acyclovir","volume":"188","author":"Baltinas","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"R25-20260527","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1002\/pbc.21638","article-title":"Valacyclovir and acyclovir pharmacokinetics in immunocompromised children","volume":"51","author":"Bomgaars","year":"2008","journal-title":"Pediatr Blood Cancer"},{"key":"R26-20260527","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/106002809703100211","article-title":"Valacyclovir","volume":"31","author":"Acosta","year":"1997","journal-title":"Ann Pharmacother"},{"key":"R27-20260527","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1086\/586903","article-title":"Double-blind study comparing 2 dosages of valacyclovir hydrochloride for the treatment of uncomplicated herpes zoster in immunocompromised patients 18 years of age and older","volume":"197","author":"Arora","year":"2008","journal-title":"J Infect Dis"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2415_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:28:05Z","timestamp":1786735685000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2415_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2415_25","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]},"assertion":[{"value":"2025-09-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}