Work

Acute Retinal Necrosis Associated Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Purpose To evaluate the success of surgical management for rhegmatogenous retinal detachment (RRD) secondary to acute retinal necrosis (ARN).Methods PubMed, Embase, ClinicalTrials, the Cochrane Library, and grey literature (2000–present) were searched for case series, interventional, and cohort studies reporting surgical repair of ARN-related RRD. Interventions included pars plana vitrectomy (PPV), scleral buckle (SB), and tamponade agents. Outcomes were final anatomical reattachment, visual acuity (VA), complications, and re-detachment. Study quality was assessed using the Newcastle–Ottawa Scale. A single-arm random-effects meta-analysis with subgroup analysis by surgical technique was performed using R.Results Twenty-three studies including 770 eyes of 680 patients were analyzed. The pooled anatomical success rate was 88% (95% CI: 79–95%), highest with PPV + SB (91%, 95% CI: 45–100%), followed by PPV + silicone oil (83%, 95% CI: 59–99%). The pooled final VA was 1.36 logMAR (95% CI: 1.18–1.54). PPV + SB achieved the best visual outcomes (0.87 logMAR, 95% CI: 0.47–1.27), while PPV + gas tamponade had the poorest (1.75 logMAR, 95% CI: −0.73–4.23); surgical technique significantly affected final VA (p = 0.028). Common complications included proliferative vitreoretinopathy (65%), optic atrophy (53%), retinal re-detachment (25%), and cataract (38%). Poorer preoperative VA was significantly associated with worse postoperative VA (p = 0.026).Conclusion Surgical repair of ARN-related RRD yields high anatomical success, but visual recovery remains limited and technique-dependent. Combined PPV + SB provides the most favorable structural and functional outcomes without increased complication risk, supporting its preferential use.

Source: Ocular Immunology and Inflammation

DOI: 10.1080/09273948.2026.2658757