title: Ocular manifestations associated with chikungunya.
abstract: 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.
authors.affiliation: Uveitis and Ocular Immunology Services, Super Speciality Eye Hospital and Postgraduate Institute of Ophthalmology, Narayana Nethralaya, Bangalore, India. padmamalini_m@yahoo.co.in
authors.forename: Padmamalini
authors.initials: P
authors.lastname: Mahendradas
authors.forename: Shylaja K
authors.initials: SK
authors.lastname: Ranganna
authors.forename: Rohit
authors.initials: R
authors.lastname: Shetty
authors.forename: Ramgopal
authors.initials: R
authors.lastname: Balu
authors.forename: Kannan M
authors.initials: KM
authors.lastname: Narayana
authors.forename: Rajesh B
authors.initials: RB
authors.lastname: Babu
authors.forename: Bhujang K
authors.initials: BK
authors.lastname: Shetty
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D007075:Immunoglobulin M; D004008:Diclofenac; D011239:Prednisolone; D000212:Acyclovir