Abstract
ABSTRACT Purpose To compare clinical manifestations and disease outcomes in Epidemic Retinitis (ER) with positive or negative Weil Felix Test (WFT). Methods Retrospective, observational, comparative study. WFT positive or negative patients formed Group 1 and 2, respectively. Patients receiving oral doxycycline monotherapy formed subgroup A and B. Duration of resolution of macular edema and retinitis was compared. Results Novel finding of “ring retinitis” was observed equally in group 1 and 2. Complete resolution of macular edema took 41.3 days (range: 30–60 days) and 43.68 days (range: 20–105 days) (p = .668) and retinitis lesions resolved in 34.3 days (range: 14–65 days) and 34 days (range: 12–60 days) (p = .875) in group A and B, respectively. All (n = 14) eyes with retinitis within 1 disc diameter of fovea improved better than 20/80 except 1. Conclusion No significant difference with respect to clinical, imaging findings and the treatment outcome was observed in WFT positive or negative cases.
Highlights
Epidemic retinitis is an uveitic entity of heterogenous etiology like Chikungunya, Dengue, West Nile virus and Rickettsial organisms.[1]
Akin to that of Fuchs’ uveitis which can be caused by viruses like CMV, HSV, VZV and rubella,[18, 19] or serpiginous like choroiditis which can be caused by tuberculosis, viruses, or which may remain idiopathic,[20] Epidemic Retinitis (ER) has unique clinical presentation, but etiology can be different
We found no significant difference in terms of ophthalmic clinical presentation, imaging findings on OCT scan and the treatment outcomes in both the groups
Summary
Epidemic retinitis is an uveitic entity of heterogenous etiology like Chikungunya, Dengue, West Nile virus and Rickettsial organisms.[1] Patients typically present with history of a recent fever. Rickettsial uveitis can have one or more of following findings: mild to moderate non granulomatous anterior uveitis, mild to moderate vitritis, disc and macular edema, and cotton wool spots like yellowish white retinitis lesions, with or without hemorrhages and focal vascular sheathing or multiple arterial plaques and vascular occlusions.[11,12,13] These clinical features can be seen in Chikungunya, Dengue and West Nile virus retinitis as well. We evaluated outcome with oral doxycycline monotherapy with or without topical steroids and/or topical nonsteroidal anti-inflammatory drugs (NSAID)
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