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Incidence and clinical characterization of retinal detachment in acute retinal necrosis: a global federated database analysis
Journal article   Open access   Peer reviewed

Incidence and clinical characterization of retinal detachment in acute retinal necrosis: a global federated database analysis

Donovin Thompson, Sidra Zafar and Meghan Berkenstock
Frontiers in ophthalmology, v 6, 1829400
08 Jun 2026
DOI: https://doi.org/10.3389/fopht.2026.1829400
PMID: 42338517
url
https://doi.org/10.3389/fopht.2026.1829400View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Science & Technology Ophthalmology
Background To determine the incidence of retinal detachment (RD) following acute retinal necrosis (ARN) and to evaluate demographic and treatment-related associations using a large, multi-institutional database. Design: Retrospective cohort study.Methods Setting: TriNetX Research Network. Study population: Patients diagnosed with ARN between January 1, 2014, and January 1, 2024. Procedures: ARN and RD were identified using ICD and CPT codes. Chi-square tests, risk ratio analyses, and logistic regression models were used to evaluate demographic and treatment-related associations of RD. Main outcome measures: Incidence and associations for RD at 3, 6, and 12 months post-diagnosis of ARN.Results Among 1,785 patients with ARN, the overall incidence of RD was 12.49% (n=223), with 135 cases (60.5%) occurring within the first 3 months of diagnosis and 88 cases (39.5%) occurring thereafter. Although aggressive combination therapy consisting of systemic corticosteroids, oral valacyclovir, and/or intravitreal foscarnet was primarily used in severe cases, RD still occurred frequently. No significant differences were observed in RD incidence based on age, sex, diabetes status, or immunosuppression.Conclusions In this large EHR-based cohort, RD following ARN occurred most commonly within the first 3 months after diagnosis. Treatment exposures (corticosteroids, valacyclovir, intravitreal foscarnet) should be interpreted strictly as proxies of disease severity, not independent risk factors for RD. These findings underscore the importance of close ophthalmic monitoring during the first 3 months after ARN diagnosis, when the risk of RD is highest.

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