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Pablo L Goldschmidt, Marie Hélène Errera, Christine Chaumeil, Christine Fardeau; Intraocular inflammation and hemorrhage associated with Dengue virus infections in Paris France. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1874.
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Viruses provoking Dengue fever have become endemic in Europe and their growing incidence is the result of developing urbanization, tourism, and trade. The goal of this work is to show the need to relate intraocular inflammation (retinitis, chorioretinitis, retinal vasculitis, optic nerve involvement, etc.) to emerging infections (Rickettsia,West Nile virus,Rif-valley virus,Dengue virus, Chikungunya virus, etc).
Patients with intraocular inflammatory diseases attending the National Eye Center (CHNO) and the University Hospital Pitie Salpetriere in Paris France were evaluated according to symptoms, signs and epidemiological data. Ocular examination included visual acuity, slit lamp examination, fundus examination through dilated pupil and color photography, enhanced depth optical coherence tomography, indocyanine green angiography, autofluorescence and fluorescein angiography. This was followed by sampling for specific antibodies titrations (including testing for Herpesviridae, Treponema, Toxoplasma, Mycobacteria, Bartonella and Lyme disease) and for Herpesviridae-DNA and Toxoplasma-DNA detection by real-time polymerase chain reaction
Three females aged 17; 30 and 21 presented fundus alterations (January-September 2014).The first reported blurred vision, and showed scotoma and retinal hemorrhage.The second visual impairment,reduction in blood perfusion assessed by indocyanine green fluorescence.The third showed perfusion increase, hemorrhages and macular edema associated with images suggesting outer retinal and retinal pigment epithelial involvement. For these 3 cases antibody titers (Ig and IgM) and titer evolution let to establish Dengue-virus associated intraocular inflammation. Prognosis varied from full resolution to partial vision loss despite intervention with symptomatic treatments.
Air travel and globalization have overturned the traditional patterns of geographic distribution of viral infections. Among others, Denguevirus associated infections require to be searched in people presenting intraocular inflammatory processes with or without hemorrhage, especially with history of travelling to endemic or epidemic regions.
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