Ocular manifestations associated with chikungunya.
OBJECTIVE
To report ocular manifestations associated with chikungunya.


METHODS
Retrospective, nonrandomized, observational case series.


METHODS
Nine chikungunya patients with ocular involvement.


METHODS
All patients with chikungunya infection presenting with ocular complaints from September 2006 to October 2006 were included in the study. The infection was confirmed by demonstration of chikungunya immunoglobulin M antibody in sera of all patients. All patients underwent an ophthalmic examination including fundus photography, fundus fluorescein angiography, confocal microscopy of keratic precipitates, and optical coherence tomography. Positive ocular changes were recorded and tabulated.


METHODS
Characteristics, frequency, and locations of ocular lesions found in the participants.


RESULTS
There were 9 patients with ocular lesions; 1 had nodular episcleritis, 5 presented with acute iridocyclitis, and 3 had retinitis. Four to 12 weeks before the development of ocular manifestations, all of these patients had fever. Although there were no specific changes of iridocyclitis that were diagnostic of the fever, the retinal changes were consistent with viral retinitis. All patients recovered from the infection with relatively good vision.


CONCLUSIONS
It appears that iridocyclitis and retinitis are the most common ocular manifestations associated with chikungunya, with a typically benign clinical course. Less frequent ocular lesions include episcleritis. All the patients responded well to the treatment with preservation of good vision. To the best of our knowledge, similar ocular manifestations associated with chikungunya infection have not been reported. In the differential diagnosis of iridocyclitis and retinitis with features suggestive of a viral infection, the entity of chikungunya-associated ocular changes should be considered in the regions affected by the epidemic.
Mahendradas
Padmamalini
P
Uveitis and Ocular Immunology Services, Super Speciality Eye Hospital and Postgraduate Institute of Ophthalmology, Narayana Nethralaya, Bangalore, India. padmamalini_m@yahoo.co.in
Ranganna
Shylaja K
SK
Shetty
Rohit
R
Balu
Ramgopal
R
Narayana
Kannan M
KM
Babu
Rajesh B
RB
Shetty
Bhujang K
BK
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018354:Alphavirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D002646:Chikungunya virus / Q000276:immunology / Q000302:isolation & purification*; D004008:Diclofenac / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D015863:Iridocyclitis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012173:Retinitis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D012189:Retrospective Studies; D015423:Scleritis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
D000914:Antibodies, Viral; D000998:Antiviral Agents; D007075:Immunoglobulin M; D004008:Diclofenac; D011239:Prednisolone; D000212:Acyclovir