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.