OPHTHALMIC MANIFESTATIONS OF DENGUE FEVER

Abstract

Objective: To describe the clinical spectrum of ophthalmic manifestations in patients presenting with dengue
fever during the outbreak at Lahore in autumn of 2011.
Study Design: Prospective study.
Place and Duration of Study: Combined Military Hospital Lahore, from Sep 2011 to Dec 2011.
Material and Methods: This prospective study was conducted at CMH Lahore. Al most 3005 clinical dengue cases
were recruited for the study from 39930 cases that reported at OPD with suspected dengue fever. All these
patients were screened for ophthalmic involvement. These patients were subjected to serological analysis for
detecting dengue specific IgM antibodies (IgM enzyme-linked immunoassay) and blood test for thrombocytopenia
after taking written informed consent. The patients with ophthalmic involvement were subjected to
detailed history, ocular examination including anterior and dilated posterior segment examination. Ophthalmic
manifestations in these patients were recorded and tabulated according to the frequency.
Results: The study showed that dengue fever could result in a variety of ocular complications. Majority of these
complications were innocuous and self limiting. Most common is subconjunctival haemorrhage. Other includes
retrobulbar haemorrhage, proptosis, increased IOP, vitreous haemorrhage, retinal haemorrhage and peri ocular
ecchymosis. Vision threatening complications were seen in only 1% of cases.
Conclusion: Dengue fever can result in a range of ocular complications so ophthalmic examination should be
performed in patients presenting with all forms of the disease. The most common is sub-conjuntival
haemorrhage. The vision threatening complications among these occur with involvement of posterior segment
including vitreous and retinal haemorrhages. This justifies detailed fund us examination of these patients with a
dilated pupil.