Herpesvirus Retinitis by Immune Status: Clinical Phenotypes and Predictors of Retinal Detachment and Severe Visual Impairment.
Acute retinal necrosis carries much higher retinal detachment risk than CMV retinitis
Herpesvirus Retinitis by Immune Status: Clinical Phenotypes and Predictors of Retinal Detachment and Severe Visual Impairment.
To evaluate the clinical manifestations, retinal detachment (retinal detachment) patterns, treatment strategies, and visual outcomes in herpesvirus retinitis and to identify predictors of retinal detachment and severe visual impairment.
Among 1175 patients screened for suspected viral retinitis (2013-2025), 120 patients (144 eyes) with acute retinal necrosis (acute retinal necrosis) or cytomegalovirus retinitis (cytomegalovirus retinitis) were included.
acute retinal necrosis raises detachment risk far more than CMV retinitis
Cytomegalovirus retinitis occurred mainly in patients with lymphoma (P = 0.022) and prior immunosuppressive therapy (P = 0.027), whereas acute retinal necrosis more commonly showed unilateral involvement (P = 0.012), peripheral necrosis (B = 1.91; P = 0.046), and a more fulminant course (B = -0.06; P < 0.001).
Retinal detachment developed earlier and more frequently in acute retinal necrosis (log-rank P < 0.001).
Surgical intervention (B = -2.50; 95% CI, -4.72 to -0.20; P = 0.033) and concurrent retinal detachment (B = -1.28; 95% CI, -2.55 to -0.02; P = 0.047) were independently associated with lower odds of severe visual impairment.
Host immune status was associated with distinct clinical phenotypes and outcome patterns in herpesvirus retinitis. Cytomegalovirus retinitis occurred in immunocompromised patients and showed a more indolent course.
acute retinal necrosis showed broader retinal involvement and earlier retinal detachment. Retinal detachment timing and surgical intervention were associated with visual outcomes.
These findings highlight distinct disease patterns and may improve early recognition and management.