Ocular involvement associated with an epidemic outbreak of chikungunya virus infection.
OBJECTIVE
To study the range of ocular symptoms in a cohort of patients with chikungunya infection.


METHODS
Retrospective, observational case series.


METHODS
Patients attending a tertiary eye care hospital in South India were included in the study. We included adult patients with serologically confirmed chikungunya virus infection who received clinical care at the Aravind Eye Hospital, Madurai, South India. They were assessed for demographic characteristics, ocular symptoms, laboratory parameters, and chikungunya virus infection severity. Patients underwent a complete ophthalmologic examination that included visual acuity, slit-lamp examination, and indirect funduscopic examination. Visual outcome at the end of three months was the main outcome measure.


RESULTS
The charts of 37 patients were analyzed based on the clinical picture and the serologic results. Forty patients were included as controls and tested negative. There were 21 males and 16 females with a mean age of 44.17 years. The main ocular symptoms included granulomatous and nongranulomatous anterior uveitis, optic neuritis retrobulbar neuritis, and dendritic lesions. Of the 26 patients who were followed up for three months, the visual acuity improved in 11 patients (42.3%), remained the same in 12 patients (46.15%), and worsened in three patients (11.5%).


CONCLUSIONS
The main ocular manifestation associated with the recent epidemic outbreak of chikungunya virus infection in South India included granulomatous and nongranulomatous anterior uveitis, optic neuritis, retrobulbar neuritis, and dendritic lesions. The visual prognosis generally was good, with most patients recovering good vision. Further studies are needed to understand the pathogenesis of this disease.
Lalitha
Prajna
P
Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, India. lalitha@aravind.org
Rathinam
Sivakumar
S
Banushree
Krishnadas
K
Maheshkumar
Shanmugam
S
Vijayakumar
Rajendran
R
Sathe
Padmakar
P
D000328:Adult; D000368:Aged; D018354:Alphavirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D000914:Antibodies, Viral / Q000097:blood; D018771:Arthralgia / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D002646:Chikungunya virus / Q000276:immunology / Q000302:isolation & purification*; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D015828:Eye Infections, Viral / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007194:India / Q000453:epidemiology; D007634:Keratitis / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D011379:Prognosis; D012189:Retrospective Studies; D014606:Uveitis, Anterior / Q000453:epidemiology / Q000276:immunology / Q000821:virology
D000914:Antibodies, Viral; D007075:Immunoglobulin M