Ocular manifestations of dengue fever in an East Indian epidemic.
BACKGROUND
The incidence and geographic distribution of dengue has increased dramatically in recent years. Previously, ocular findings in dengue fever were considered rare. We report a spectrum of ocular manifestations of this potentially fatal disease and its association with laboratory parameters.


METHODS
134 patients hospitalized with a diagnosis of dengue fever during an epidemic were included. Systemic and ophthalmic examinations were completed on all patients.


RESULTS
The mean age was 31.3 years and 63.4% were males. All patients presented with fever. Six (4.5%) patients had retrobulbar pain and none of the patients presented with any visual complaints. Ocular findings were present in 54 (40.3%) patients. Subconjunctival haemorrhage was the commonest eye finding seen in 50 patients, of whom 84% had characteristic petechial type of haemorrhages. Fundus findings present in 10 (7.5%) patients included dilatation and tortuosity of vessels, superficial retinal haemorrhages, cotton-wool spots, and hard exudates; the macula, however, was spared in all patients. Only 6 of the patients with posterior segment involvement returned for follow-up examination and it was found that retinal changes had resolved without any specific treatment within 2 to 8 weeks time. Of all laboratory parameters evaluated, marked thrombocytopenia (platelet count <50,000/microL) emerged to be significantly associated with ocular haemorrhage.


CONCLUSIONS
Multiple subconjunctival haemorrhages, especially petechial type, are a common manifestation of dengue infection. Dengue fever patients with marked thrombocytopenia are predisposed to spontaneous ocular haemorrhages.
Kapoor
Harpreet K
HK
Christian Medical College and Hospital, Ludhiana, Punjab, India. harpreet_kapoor@hotmail.com
Bhai
Saloni
S
John
Mary
M
Xavier
Jai
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003715:Dengue / Q000150:complications / Q000453:epidemiology*; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D005130:Eye Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies