Ocular manifestations in dengue fever

Abstract

PurposeDengue fever, a viral disease epidemic in some parts of the world, caused by a virus, is characterized by fever, headache, muscle and joint pains. Ocular manifestations are uncommon, but of great significance. Main symptoms include blurring of vision, scotomata, metamorphopsia, and floaters. We describe the clinical spectrum of fundus manifestations and angiographic, optical coherence tomographic and electrophysiology features of dengue‐ associated maculopathy in few patient.MethodsWe reviewed clinical records and report 6 serial cases of ophthalmic complications resulting from dengue infection. Serology was positive in 100%. Investigations included Humphrey automated visual field analyzer, optical coherence tomography, fundus fluorescein and indocyanine green angiography, and electrophysiology.Results12 eyes of 6 patients, 5 women and 1 man, were studied. The mean age was 26.8 years.The mean log MAR presenting best corrected visual acuity was 0.53 (range of 1 to counting fingers). Multiple retinal yellowish deposits at fovea were an usual finding in 9 eyes. Of these, optical coherence tomography (OCT) showed focal disruption of the outer neurosensory retina in 8 eyes, and indocyanine green angiography corresponding hypofluorescent spots in 3 eyes. Intraretinal hemorrhage was seen in 1 eye, in association with an artery sheathing. In this case, OCT showed a thickening of the inner retina, the result of retinal arteriolar occlusion. Central or paracentral scotomas were observed in 83%. Multifocal electroretinography showed decreased foveal and parafoveal responses. Final visual acuity increased while relativ scotoma remained.ConclusionsOcular damage in Dengue fever are extremely varied and all examinations are needed to better characterize the lésion and thus assess the best visual prognosis of often young and active patients.