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Helen Mi, Muhammad Amir Bin Ismail, Stephen Charn Beng Teoh, Su Ling Ho, Rupesh Agrawal; Clinical Features and Visual Prognosis in Dengue Uveitis in Singapore over 12 Years. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4183.
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This study aims to report the clinical features including complications, and visual prognosis of dengue uveitis patients seen by a tertiary eye center in Singapore over the duration of 12 years.
We conducted a retrospective analysis of 53 consecutive dengue uveitis cases, out of a total of 1666 cases, between 2004-2015. Diagnosis for dengue uveitis was confirmed with serological investigation detecting IgM antibodies to the dengue virus. Data collected included clinical symptoms, examination findings, ocular complications, presenting visual acuity and final visual acuity after resolution.
There were a total of 93 affected eyes. Majority of the patients (n=40, 75.5%) had bilateral disease. The mean age was 30.92±11.1. The most common clinical symptoms at presentation was blurring of vision (n=40, 75.5%), followed by floaters (n=9, 17.0%), metamorphopsia (n=3, 5.7%) and scotoma (n=3, 5.7%). Almost all of the patients had systemic symptoms of dengue fever (n=50, 94.3%). The most common clinical findings was retinal vasculitis (n=30, 56.6%), followed by unifocal retinochoroiditis (n=10, 18.9%), optic nerve hyperemia (n=6, 11.3%), and anterior chamber activity (n=6, 11.3%). 52 patients (98.1%) had posterior uveitis, while 1 patient (1.9%) presented with panuveitis. 1 patient had concurrent systemic lupus erythematosus on rituximab, and the rest of the patients were immunocompetent (n=52, 98.1%). 6 of the patients had complication of cystoid macular edema (11.3%), and 1 patient had uveitic glaucoma (1.9%). 52 patients (98.1%) of the patients did not have any recurrences. The visual acuity at presentation ranged from 20/20 to counting fingers at 1 meter, out of which 36.6% of eyes had visual acuity worse than 20/40 (n=34). After resolution of the disease, all eyes (n=93, 100.0%) had vision of 20/40 or better, and 78.5% of the eyes had vision of 20/25 or better (n=86). This difference was statistically significant at p<0.05 (p=0.00).
Dengue uveitis typically manifests as posterior uveitis, with the commonest presentation being retinal vasculitis. In our study, majority of the patients are immunocompetent, and had systemic symptoms of dengue fever. All patients had good visual outcome following resolution, with visual acuity of 20/40 or better. Most patients did not have any recurrences in our study.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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