Intravitreal dexamethasone as an adjunct for the treatment of dengue virus related maculopathy: a case report
DOI:
https://doi.org/10.18203/2349-3933.ijam20184310Keywords:
AION, Centrocecal scotoma, Dengue, Intravitreal dexamethasone, Maculopathy, NeuroretinitisAbstract
Dengue infection related ocular pathology whether as a direct manifestation of coagulopathy or as a sequale of immunological reaction is being increasingly recognized in endemic regions and has expanded out into a spectrum with pan ocular presentation. Authors present a case of a young female from an endemic region who developed visual field abnormality and loss of vision several days after onset of fever. She was diagnosed with dengue virus infection and subsequently went on to develop thrombocytopenia requiring transfusion. Detailed ophthalmological evaluation revealed maculae edema, and changes consistent with neuroretinitis and posterior segment vasculitis. She was treated with a combination of pulse steroid therapy and intravitreal dexamethasone injection. Patient went on to have excellent visual recovery on follow up with no persisting visual field deficit.
References
Monath TP, Heinz FZ. Flaviviruses. In: Fields BN, Knipe DM, Howley PM, et al., editors. Fields virology, 3rd ed. Philadelphia: Lippincott Raven Publishers; 1996:961-1034.
Ng AW, Teoh SC. Dengue eye disease. Survey of Ophthalmology. 2015. Elsevier USA. 2015, March 1. Available at: https://doi.org/10.1016/j.survophthal.2014.07.003
Lim WK, Mathur R, Koh A, Yeoh R, Chee SP. Ocular manifestations of dengue fever. Ophthalmology. 2004 Nov 1;111(11):2057-64.
Ramakrishnan R, Shrivastava S, Deshpande S, Patkar P. Anterior ischemic optic neuropathy following dengue fever. Oman J Ophthalmol. 2016 Sep;9(3):160.
Juanarita J, Azmi MN, Azhany Y, Liza-Sharmini AT. Dengue related maculopathy and foveolitis. Asian Pacific J Tropical Biomed. 2012 Sep;2(9):755-6.
Sumardi U, Nelwan EJ. Retinal hemorrhage in dengue hemorrhagic fever. Acta Med Indones. 2011 Jan;43(1):66-7.
Teoh SC, Chee CK, Laude A, Goh KY, Barkham T, Ang BS, Eye Institute Dengue-Related Ophthalmic Complications Workgroup. Optical coherence tomography patterns as predictors of visual outcome in dengue-related maculopathy. Retina. 2010 Mar 1;30(3):390-8.
Bacsal KE, Chee SP, Cheng CL, Flores JV. Dengue-associated maculopathy. Arch Ophthalmol. 2007 Apr;125(4):501-10.
Chang PE, Cheng CL, Asok K, Fong KY, Chee SP, Tan CK. Visual disturbances in dengue fever: an answer at last. Singapore Med J. 2007 Mar;48(3):71-3.