Predictive effect of intraocular fluid testing in retinal detachment secondary to acute retinal necrosis syndrome_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhao Yue ^1,2 , Tang Lingyun ¹ , Yao Jin ¹ , Jiang Qin ¹ ,  Zhang Mingshun ²

1. Nanjing Medical University Eye Hospital, Nanjing 210029, China;
2. Department of Immunology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing 210029, China;

Corresponding author：

Zhang Mingshun, Email: mingshunzhang@njmu.edu.cn

Keywords：

Acute retinal necrosis syndrome; Retinal detachment; Aqueous humor; Viral nucleic acid; Cell factor

DOI：

10.3760/cma.j.cn511434-20231215-00488

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Objective To explore the predictive effect of intraocular fluid testing in the assessment of retinal detachment (RD) occurring in acute retinal necrosis syndrome (ARN). Methods A retrospective study. From January 2019 to October 2023, 40 patients with 40 eyes diagnosed as ARN in Nanjing Medical University Eye Hospital were collected for this study. According to whether RD occurred during the follow-up period, the patients were divided into RD group (group A) and no RD group (group B), with 18 patients 18 eyes and 22 patients 22 eyes, respectively. All patients were given intravitreal 20 mg/ml ganciclovir 0.1 ml (ganciclovir 2 mg), 2 to 3 times per week after diagnosis. The concentrations of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (BFGF), vascular cell adhesion factor (VCAM), interleukin (IL)-6, IL-8, and IL-10 in the preaqueous solution were measured before the first injection of ganciclovir. The loads of herpes simplex virus (HSV) and varicella-herpes zoster virus (VZV) were detected by fluorescence quantitative polymerase chain reaction. Receiver operating characteristic curve (ROC curve) calculated and analyzed the area under ROC curve (AUC) of inflammatory cytokines in aqueous humor and HSV-DNA and VZV-DNA loads in predicting RD in ARN patients to evaluate their predictive value. Results In 18 eyes in group A and 22 eyes in group B, VZV and HSV was infected in 16 and 2 eyes and 21 and 1 eyes, respectively. The VZV-DNA and HSV-DNA load were compared between the two groups, the difference was statistically significant (Z=－3.762, P＜0.001); compared with group B, the concentrations of VEGF in humor (Z=－3.996), BFGF (Z=－2.430), IL-6 (Z=－3.303), IL-8 (Z=－3.480), and IL-10 (Z=－3.409) increased significantly in group A, the difference was statistically significant (P＜0.05); there was no statistically significant difference in VCAM between the two groups (Z=－0.054, P=0.957). The ROC curve analysis showed that the AUC of VEGF, nucleic acid copies, IL-10, IL-8, IL-6, and bFGF for predicting RD in ARN was 0.871, 0.848, 0.828, 0.823, 0.806, 0.737, respectively. The AUC of combination of VEGF, IL-10, IL-8, IL-6, and BFGF predicted the RD in ARN was 0.924. The optimal cut-off value of nucleic acid copies was 0.40×10⁶, and IL-10, IL-8 and IL-6 were 50.65, 1 695.50 and 6 634.0 pg/ml, respectively. Conclusion Aqueous humor viral load as well as cytokines alone or in combination have a reference value for predicting RD secondary to ARN.

Citation： Zhao Yue, Tang Lingyun, Yao Jin, Jiang Qin, Zhang Mingshun. Predictive effect of intraocular fluid testing in retinal detachment secondary to acute retinal necrosis syndrome. Chinese Journal of Ocular Fundus Diseases, 2024, 40(7): 512-517. doi: 10.3760/cma.j.cn511434-20231215-00488 Copy

1.	Lau CH, Missotten T, Salzmann J, et al. Acute retinal necrosis features, management, and outcomes[J]. Ophthalmology, 2007, 114(4): 756-762. DOI: 10.1016/j.ophtha.2006.08.037.
2.	李程, 周旻, 雷博雅, 等. 急性视网膜坏死患者接受抗病毒治疗后眼底坏死面积与房水病毒载量的动态变化分析[J]. 中国眼耳鼻喉科杂志, 2022, 22(5): 485-487. DOI: 10.14166/j.issn.1671-2420.2022.05.011.Li C, Zhou M, Lei BY, et al. Time profile of viral loads in aqueous humor and fundus necrosis area changes in acute retinal necrosis patients after antiviral treatment[J]. Chin J Ophthalmol and Otorhinolaryngol, 2022, 22(5): 485-487. DOI: 10.14166/j.issn.1671-2420.2022.05.011.
3.	Schoenberger SD, Kim SJ, Thorne JE, et al. Diagnosis and treatment of acute retinal necrosis: a report by the American Academy of Ophthalmology[J]. Ophthalmology, 2017, 124(3): 382-392. DOI: 10.1016/j.ophtha.2016.11.007.
4.	刘夕瑶, 毛菲菲, 李丹, 等. 房水病毒载量和细胞因子检测在急性视网膜坏死诊断与治疗中应用的临床研究[J]. 中华眼科医学杂志(电子版), 2022, 12(2): 76-81. DOI: 10.3877/cma.j.issn.2095-2007.2022.02.003.Liu XY, Mao FF, Li D, et al. The role of aqueous humor viral load and inflammatory cytokines in patients with acute retinal necrosis for the diagnosis and treatment[J]. Chin J Ophthalmol Med (Electronic Edition), 2022, 12(2): 76-81. DOI: 10.3877/cma.j.issn.2095-2007.2022.02.003.
5.	Anthony CL, Bavinger JC, Yeh S. Advances in the diagnosis and management of acute retinal necrosis[J]. Ann Eye Sci, 2020, 9(5): 28. DOI: 10.21037/aes-2019-dmu-09.
6.	Risseeuw S, de Boer JH, Ten Dam-van Loon NH, et al. Risk of rhegmatogenous retinal detachment in acute retinal necrosis with and without prophylactic intervention[J]. Am J Ophthalmol, 2019, 206: 140-148. DOI: 10.1016/j.ajo.2019.05.023.
7.	Holland GN. Standard diagnostic criteria for the acute retinal necrosis syndrome. Executive Committee of the American Uveitis Society[J]. Am J Ophthalmol, 1994, 117(5): 663-667. DOI: 10.1016/s0002-9394(14)70075-3.
8.	Shantha JG, Weissman HM, Debiec MR, et al. Advances in the management of acute retinal necrosis[J]. Int Ophthalmol Clin, 2015, 55(3): 1-13. DOI: 10.1097/IIO.0000000000000077.
9.	汤凌云, 张荟颖, 赵玥, 等. 眼内液检测在急性视网膜坏死预后评估中的作用[J]. 中华眼底病杂志, 2023, 39(9): 767-769. DOI: 10.3760/cma.j.cn511434-20220310-00127.Tang LY, Zhang HY, Zhao Y, et al. The value of intraocular fluid detection in the prognostic evaluation of acute retinal necrosis[J]. Chin J Ocul Fundus Dis, 2023, 39(9): 767-769. DOI: 10.3760/cma.j.cn511434-20220310-00127.
10.	Zhang P, Liu S, Wang Z, et al. Immune cell status and cytokines profiles in patients with acute retinal necrosis[J]. Ocul Immunol Inflamm, 2021, 29(7-8): 1452-1458. DOI: 10.1080/09273948.2020.1734214.
11.	de Visser L, de Boer JH, Rijkers GT, et al. Cytokines and chemokines involved in acute retinalnecrosis[J]. Invest Ophthalmol Vis Sei, 2017, 58(4): 2139-2151. DOI: 10.1167/iovs.16-20799.
12.	Sato M, Abe T, Tamai M. Expression of the varicella-zoster virus thymidine kinase and cytokines in patients with acute retinal necrosis syndrome[J]. Jpn J Ophthalmol, 2000, 44(6): 693. DOI: 10.1016/s0021-5155(00)00254-9.
13.	Rojas JM, Avia M, Martín V, et al. IL-10: a multifunctional cytokine in viral infections[J/OL]. J Immunol Res, 2017, 2027: 6104054[2017-02-20]. https://pubmed.ncbi.nlm.nih.gov/28316998/. DOI: 10.1155/2017/6104054.
14.	Suzuki J, Goto H, Minoda H, et al. Analysis of retinal findings of acute retinal necrosis using optical coherence tomography[J]. Ocul Immunol Inflamm, 2006, 14(3): 165-170. DOI: 10.1080/09273940600672198.

1. Lau CH, Missotten T, Salzmann J, et al. Acute retinal necrosis features, management, and outcomes[J]. Ophthalmology, 2007, 114(4): 756-762. DOI: 10.1016/j.ophtha.2006.08.037.
2. 李程, 周旻, 雷博雅, 等. 急性视网膜坏死患者接受抗病毒治疗后眼底坏死面积与房水病毒载量的动态变化分析[J]. 中国眼耳鼻喉科杂志, 2022, 22(5): 485-487. DOI: 10.14166/j.issn.1671-2420.2022.05.011.Li C, Zhou M, Lei BY, et al. Time profile of viral loads in aqueous humor and fundus necrosis area changes in acute retinal necrosis patients after antiviral treatment[J]. Chin J Ophthalmol and Otorhinolaryngol, 2022, 22(5): 485-487. DOI: 10.14166/j.issn.1671-2420.2022.05.011.
3. Schoenberger SD, Kim SJ, Thorne JE, et al. Diagnosis and treatment of acute retinal necrosis: a report by the American Academy of Ophthalmology[J]. Ophthalmology, 2017, 124(3): 382-392. DOI: 10.1016/j.ophtha.2016.11.007.
4. 刘夕瑶, 毛菲菲, 李丹, 等. 房水病毒载量和细胞因子检测在急性视网膜坏死诊断与治疗中应用的临床研究[J]. 中华眼科医学杂志(电子版), 2022, 12(2): 76-81. DOI: 10.3877/cma.j.issn.2095-2007.2022.02.003.Liu XY, Mao FF, Li D, et al. The role of aqueous humor viral load and inflammatory cytokines in patients with acute retinal necrosis for the diagnosis and treatment[J]. Chin J Ophthalmol Med (Electronic Edition), 2022, 12(2): 76-81. DOI: 10.3877/cma.j.issn.2095-2007.2022.02.003.
5. Anthony CL, Bavinger JC, Yeh S. Advances in the diagnosis and management of acute retinal necrosis[J]. Ann Eye Sci, 2020, 9(5): 28. DOI: 10.21037/aes-2019-dmu-09.
6. Risseeuw S, de Boer JH, Ten Dam-van Loon NH, et al. Risk of rhegmatogenous retinal detachment in acute retinal necrosis with and without prophylactic intervention[J]. Am J Ophthalmol, 2019, 206: 140-148. DOI: 10.1016/j.ajo.2019.05.023.
7. Holland GN. Standard diagnostic criteria for the acute retinal necrosis syndrome. Executive Committee of the American Uveitis Society[J]. Am J Ophthalmol, 1994, 117(5): 663-667. DOI: 10.1016/s0002-9394(14)70075-3.
8. Shantha JG, Weissman HM, Debiec MR, et al. Advances in the management of acute retinal necrosis[J]. Int Ophthalmol Clin, 2015, 55(3): 1-13. DOI: 10.1097/IIO.0000000000000077.
9. 汤凌云, 张荟颖, 赵玥, 等. 眼内液检测在急性视网膜坏死预后评估中的作用[J]. 中华眼底病杂志, 2023, 39(9): 767-769. DOI: 10.3760/cma.j.cn511434-20220310-00127.Tang LY, Zhang HY, Zhao Y, et al. The value of intraocular fluid detection in the prognostic evaluation of acute retinal necrosis[J]. Chin J Ocul Fundus Dis, 2023, 39(9): 767-769. DOI: 10.3760/cma.j.cn511434-20220310-00127.
10. Zhang P, Liu S, Wang Z, et al. Immune cell status and cytokines profiles in patients with acute retinal necrosis[J]. Ocul Immunol Inflamm, 2021, 29(7-8): 1452-1458. DOI: 10.1080/09273948.2020.1734214.
11. de Visser L, de Boer JH, Rijkers GT, et al. Cytokines and chemokines involved in acute retinalnecrosis[J]. Invest Ophthalmol Vis Sei, 2017, 58(4): 2139-2151. DOI: 10.1167/iovs.16-20799.
12. Sato M, Abe T, Tamai M. Expression of the varicella-zoster virus thymidine kinase and cytokines in patients with acute retinal necrosis syndrome[J]. Jpn J Ophthalmol, 2000, 44(6): 693. DOI: 10.1016/s0021-5155(00)00254-9.
13. Rojas JM, Avia M, Martín V, et al. IL-10: a multifunctional cytokine in viral infections[J/OL]. J Immunol Res, 2017, 2027: 6104054[2017-02-20]. https://pubmed.ncbi.nlm.nih.gov/28316998/. DOI: 10.1155/2017/6104054.
14. Suzuki J, Goto H, Minoda H, et al. Analysis of retinal findings of acute retinal necrosis using optical coherence tomography[J]. Ocul Immunol Inflamm, 2006, 14(3): 165-170. DOI: 10.1080/09273940600672198.

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Predictive effect of intraocular fluid testing in retinal detachment secondary to acute retinal necrosis syndrome

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