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Anne-Laure Remond, Nathalie Butel, Christine Fardeau, Marie-Hélène Errera, Phuc LeHoang, Bahram Bodaghi; OCULAR MANIFESTATIONS IN DENGUE FEVER. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3301.
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© ARVO (1962-2015); The Authors (2016-present)
Dengue 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 a few patients.
We reviewed clinical records and report 6 consecutive cases of ophthalmic complications resulting from dengue virus infection. Serology was positive in all patients. Investigations included Humphrey automated visual field analyzer, optical coherence tomography, fundus fluorescein and indocyanine green angiography, and electrophysiology.
12 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 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 hemorrhages were 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% of cases. Multifocal electroretinography showed decreased foveal and parafoveal responses. Final visual acuity increased while relative scotoma remained.
Ocular damage in Dengue fever is extremely variable and all investigations are needed to better characterize the lesion and thus assess the best visual prognosis of often young and active patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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