The first report in the medical literature of the uveitic entity known as acute retinal necrosis (ARN) was published in Japan in 1971.1 In the English literature, in 1977, two additional patients were described with a rapidly progressive retinal vasculitis that involved both the arteries and veins and was accompanied by retinal opacifkation.2 Both of these patients developed necrotic retinas and irreparable retinal detachments with final visual acuities of only light perception. This syndrome was given the name bilateral acute retinal necrosis in a 1978 description of 4 patients with bilateral processes similar to that described previously.3 Five of 8 eyes developed retinal detachments with breaks found at the border of normal and abnormal retina. Systemic workup was negative in all 4 patients. The etiology was hypothesized to be either an inflammatory or infectious retinitis. In 1982, a summary of the available medical literature on ARN codified the dismal prognosis of the disease entity that at that time had no known treatment.4 Sixty-six percent of cases were bilateral and 75% developed a retinal detachment that could only be successfully reattached in 22% of cases; 69% of eyes had a final visual acuity of hand motions or worse. The attempted treatments at the time which were universally ineffective included systemic or periocular steroids, cytotoxic chemotherapeutic agents, and use of transfer factor.
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