Abstract
Objectives
To observe the changes of viral load in aqueous humour samples and visual outcomes in varicella zoster virus (VZV)-induced acute retinal necrosis (ARN).
Methods
Observational retrospective study. Medical records and viral load measured by real-time quantitative polymerase chain reaction (qPCR) of 20 eyes with VZV-induced ARN were reviewed.
Results
The mean viral load at presentation was 5.7 × 107 ± 9.7 × 107 copies/mL. An initial plateau phase for viral load lasting up to 2 weeks occurred in most eyes (18 eyes, 90%). In the following logarithmic reduction phase, the mean slope of the decline in viral load was −0.103 ± 0.029 log/day, and the expected time for half reduction of the initial viral load was 3.2 ± 1.0 days. At the end of the first 8-week’s antiviral treatment, the viral load was below detection threshold in all 20 eyes (100.0%). The mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from 1.1 ± 0.7 (Snellen equivalent 20/250) to 0.7 ± 0.6 (Snellen equivalent 20/100) after a follow-up of 8.6 ± 2.0 months. Thirteen of the 20 eyes (65.0%) suffered retinal detachment and underwent vitrectomy. The initial viral load was the independent predictive factor of logMAR BCVA at the last follow-up (β = 0.745, P < 0.001).
Conclusions
The observation of viral load changes by qPCR was useful for better monitoring of therapeutic efficacy and deciding needed antiviral duration in VZV-induced ARN patients.
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Acknowledgements
The authors thank Jianhong Dong and Zhijian Jiang (Shanghai Xuhui Central Hospital) for collecting data, and thank all patients involved in the study for their contributions in sample collection.
Funding
This work was supported by the National Natural Science Foundation of China (Grant no. 81770944 and 81700862), Grant from Science and Technology Commission of Shanghai Municipality (Grant no. 16411953700 and 18411965100), Xuhui District Health and Family Planning Commission Key Disease Joint Project (XHLHGG201807).
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BL and ZW contributed equally to the paper. BL and MZ designed the study. The main part of the paper was drafted by BL and ZW. The paper was revised by QC, GX and MZ. Clinical data were collected, interpretated and added to the paper by BL, QS, RG, YZ and RJ. PCR analysis were conducted by ZW.
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Lei, B., Wang, Z., Shu, Q. et al. Observation of varicella zoster virus-induced acute retinal necrosis: viral load detection and visual outcome. Eye 36, 1209–1216 (2022). https://doi.org/10.1038/s41433-021-01609-8
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DOI: https://doi.org/10.1038/s41433-021-01609-8
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