title: Ocular manifestations of dengue fever in an East Indian epidemic.
abstract: 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.
authors.affiliation: Christian Medical College and Hospital, Ludhiana, Punjab, India. harpreet_kapoor@hotmail.com
authors.forename: Harpreet K
authors.initials: HK
authors.lastname: Kapoor
authors.forename: Saloni
authors.initials: S
authors.lastname: Bhai
authors.forename: Mary
authors.initials: M
authors.lastname: John
authors.forename: Jai
authors.initials: J
authors.lastname: Xavier
mesh_terms: 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