Objective To investigate the influencing factors of prognostic vision of affected eyes in acute retinal necrosis syndrome (ARNS).

Methods The clinical data of 31 patients (37 eyes) with ARNS were retrospectively analyzed. According to the best corrected visual acuity (BCVA) at the last follow-up, the affected eyes were divided into group A (24 eyes, BCVA≥0.1) and group B (13 eyes, BCVA < 0.1). The differences of demographic characteristics, baseline ocular symptoms, treatment methods and other parameters between the two groups were compared. Logistic regression analysis was used to identify the risk factors for prognostic vision of affected eyes of ARNS patients, and receiver operating characteristic (ROC) curve was drawn for verification.

Results Up to the last follow-up, the BCVA was below 0.1 in 35.14%(13/37)of the affected eyes in this study and the incidence of retinal detachment(RD) was 51.35%. In 20 eyes treated with vitrectomy, the long-term resetting rate of retinal anatomical structure was 95.00%. Compared with group B with poor visual prognosis, group A had better BCVA at initial medical visit, less lesions involved macula, lower incidence of RD, mild vitreous inflammation, most of necrotizing retinitis involved the peripheral area of zone three, and fundus retinal necrosis area was small, the differences were statistically significant (P < 0.05). Multivariate Logistic regression analysis showed that poor BCVA at initial medical visit(OR=0.066; 95%CI, 0.007 to 0.665; P=0.021) and occurrence of RD (OR=0.011; 95%CI, 0.001 to 0.341; P=0.010) were independent risk factors for poor visual recovery in ARNS patients. ROC curve analysis showed that RD (AUC=0.840; 95%CI, 0.709 to 0.970) had better efficacy than initial BCVA (AUC=0.772; 95%CI, 0.595 to 0.950) in predicting poor visual prognosis in patients with ARNS.

Conclusion The prognosis of acute retinal necrosis is related to BCVA at initial medical visit and occurrence of RD.