title: Ocular characteristics in nephropathia epidemica or Puumala virus infection.
abstract: OBJECTIVE
  We documented the largest series so far concerning the ocular characteristics of nephropathia epidemica.
  
  
  METHODS
  A total of 37 consecutive nephropathia epidemica patients underwent a comprehensive ophthalmic examination during hospitalization for systemic infection, and a control examination after recovery.
  
  
  RESULTS
  The most common ocular symptoms were: frontal headache or periocular pain (75.6%), blurred vision (54.1%) and photophobia (10.8%). The best corrected visual acuity of 7 patients (18.9%) was reduced during the acute phase as compared to the later control examination. Myopic shift was found in 15 patients (40.5%), three of whom (8.1%) developed real transient myopia. There were no attacks of angle closure glaucoma in this series. On the contrary, the intraocular pressure was decreased in 49 eyes (66.2%) during the acute stage of the disease. Lid edema was present in 28 eyes (37.8%), conjunctival injection in 20 eyes (27.0%), chemosis in 8 eyes (10.8%) and subconjuctival bleeding in 3 eyes (4.1%). Signs of acute anterior uveitis were found in 10 eyes (13.5%), however, this resolved without treatment. In one eye retinal edema with hemorrhages was detected. Ultrasonography revealed narrowing of the anterior chamber during the acute phase in 69 eyes (93.2%) and thickening of the crystalline lens in 64 eyes (86.5%).
  
  
  CONCLUSIONS
  Ophthalmic findings in nephropathia epidemica are not uncommon. The symmetry of the clinical manifestations reflects the systemic nature of the underlying infection.
authors.affiliation: Department of Ophthalmology, Savonlinna Central Hospital, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kontkanen
authors.forename: T
authors.initials: T
authors.lastname: Puustjärvi
authors.forename: P
authors.initials: P
authors.lastname: Kauppi
authors.forename: J
authors.initials: J
authors.lastname: Lähdevirta
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D002648:Child; D005128:Eye Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006480:Hemorrhagic Fever with Renal Syndrome / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007429:Intraocular Pressure; D007908:Lens, Crystalline / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology; D011446:Prospective Studies; D014792:Visual Acuity