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Ocular manifestations in dengue fever

Session Details

Session Title: Uveitis & Intraocular Tumours

Session Date/Time: Friday 27/09/2013 | 14:30-16:00

Paper Time: 15:02

Venue: Hall C (Level 1)

First Author: T.Gregorio PORTUGAL

Co Author(s):    M. Macedo   F. Trindade   C. Pestana   R. Pereira     

Abstract Details

Purpose:

To characterize ocular manifestations associated with dengue fever (DF) in the first outbreak of this arboviral disease in Portugal. Vector-borne diseases present a re-emerging threat to Europe and require particular attention.

Setting:

Department of Ophthalmology, Dr. Nélio Mendonça Hospital, Funchal, Portugal.

Methods:

Clinical and imaging records of patients with ocular symptoms and serologic evidence of DF were analyzed. All patients underwent complete ophthalmologic examination, including best corrected visual acuity (BCVA), slit-lamp biomicroscopy and dilated fundus examination. Optical coherence tomography (OCT), fundus fluorescein angiography (FFA), Amsler grid testing and automated perimetry were performed. Treatment and visual outcomes were registed.

Results:

Fifteen eyes of eleven patients (4 men and 7 women; mean age 40.1 years) were identified. Symptoms included generalized blurring of vision and scotoma, each in 9 eyes (60%) and floaters in 2 eyes (13%). Ocular symptoms were noted 11.9 ± 8.1 days (range 3-30) after the onset of fever. Ocular involvement was unilateral in 64% of patients. Initial BCVA varied from 20/20 to 20/400. Intraretinal hemorrhages were seen in 8 eyes (53%), macular edema in 3 eyes (20%) and neurosensory detachment in 1 eye. Anterior chamber cells were observed in 1 eye. Amsler grid was consistently altered. Steroid treatment was done in two patients. Significant improvement in mean BCVA was noted between weeks 1 and 4. All eyes had visual acuity of 20/40 or better and 71% of eyes achieved 20/20 of BCVA.

Conclusions:

Dengue-associated maculopathy and inflammation is an emerging ophthalmic condition and European ophthalmologists need to recognize its clinical features and treatment. FFA, OCT and visual field testing are useful tools in the diagnosis and follow-up of dengue-maculopathy.

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