According to the American Uveitis Society criteria, which pattern of retinal involvement best describes acute retinal necrosis?
- A A single central macular lesion with slow centripetal enlargement over several months
- B Multifocal punctate haemorrhages and cotton wool spots concentrated around the optic disc with minimal vitritis
- C Confluent necrotising lesions in the peripheral retina with discrete borders, progressing rapidly in a circumferential direction while sparing the posterior pole early in the disease ✓
- D Diffuse serous detachment of the neurosensory retina with leopard spot pigmentary changes
Correct answer: C. Confluent necrotising lesions in the peripheral retina with discrete borders, progressing rapidly in a circumferential direction while sparing the posterior pole early in the disease
Explanation
Acute retinal necrosis is defined by one or more foci of retinal necrosis with discrete borders in the peripheral retina, rapid progression, circumferential spread, occlusive vasculopathy, and a prominent inflammatory reaction in the vitreous and anterior chamber. The macula is spared early, which distinguishes it from progressive outer retinal necrosis seen in advanced AIDS, where necrosis is deeper, more extensive, and occurs with minimal inflammation.
Reference: Yanoff and Duker, Ophthalmology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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