Correlation of Clinical Prognosis with the Changes of Aqueous Viral Load and Interleukin-8 Levels in Patients with Acute Retinal Necrosis.

PURPOSE: To investigate the correlation between viral load, interleukin-8 (IL-8) levels and clinical outcomes during antiviral therapy in patients with acute retinal necrosis (ARN). METHODS: Before intravitreal injections of ganciclovir, aqueous humor samples were collected from 43 ARN patients (53 eyes). Viral load was quantified using polymerase chain reaction (PCR) and IL-8 concentrations were analyzed using enzyme-linked immunosorbent assay (ELISA). Relevant medical records and clinical characteristics were collected for analysis. RESULTS: Varicella zoster virus (VZV) was detected in 49 eyes (92.5%). No significant difference in Best-corrected visual acuity (BCVA) was found between baseline and final follow-up (p = 0.43). In VZV-induced ARN eyes, those with high initial viral loads (≥5.0 × 106 copies/ml) had significantly worse baseline and final BCVA than those with low viral load (p1 < 0.01, p2 < 0.01). Worse final BCVA correlated positively with both higher baseline VZV DNA loads (r = 0.14, p < 0.01) and elevated IL-8 levels (r = 0.26, p < 0.01). After treatment, viral load and IL-8 levels showed a plateau phase and a subsequent decrease. The viral load plateau lasted two weeks, while the IL-8 plateau lasted only one week. Viral load changes were positively correlated with IL-8 changes after antiviral therapy (r = 0.33, p < 0.01). CONCLUSION: Monitoring aqueous viral load and IL-8 levels may serve as a potential indicator for assessing the efficacy of antiviral treatment. Notably, IL-8 demonstrates greater sensitivity in reflecting the treatment response.