Retinal profile: a clinical indicator of severity in dengue fever in a suburban Indian environment.
OBJECTIVE
To study the retinal changes in subjects suffering from dengue fever and check if these changes can be taken as sufficient indicator of severity and progression of the disease.


METHODS
A detailed history was recorded of 118 patients on whom ocular examination, including direct ophthalmoscopy, indirect ophthalmoscopy and coloured fundus photography, was performed.


RESULTS
Forty-seven percent of patients were found to have posterior segment abnormalities. Retinal vein dilatation or tortuosity was the most common finding followed by changes in the optic disc (8.4% of patients) and background haemorrhage (6.7% of patients). With increasing severity of thrombocytopenia, the proportion of patients with retinal abnormalities increased. In patients with grade I thrombocytopenia, no fundal abnormality was found. In those with grade II thrombocytopenia, fundal abnormality was found in 13.63% patients, whereas in the grade III category it was 27.90%.


CONCLUSIONS
Severity of thrombocytopenia had a significant association with retinal abnormalities. Occurrence of fundus changes increases with an increase in severity of thrombocytopenia. Fundus changes were found in all patients with grade IV thrombocytopenia.
Associate Professor, Ophthalmology Department, Era's Lucknow Medical College & Hospital, Lucknow, India docrubie@hotmail.com.
Rubii
R
Malhotra
Professor, Ophthalmology Department, Era's Lucknow Medical College & Hospital, Lucknow, India.
Luxmi
L
Singh
Associate Professor, Ophthalmology Department, Era's Lucknow Medical College & Hospital, Lucknow, India.
R K
RK
Bundela
Professor, Ophthalmology Department, Era's Lucknow Medical College & Hospital, Lucknow, India.
Pragati
P
Garg
Resident, Ophthalmology Department, Era's Lucknow Medical College & Hospital, Lucknow, India.
Diva
D
Kant
Resident, Ophthalmology Department, Era's Lucknow Medical College & Hospital, Lucknow, India.
Ankit
A
Garg
Professor & Head, Ophthalmology Department, Era's Lucknow Medical College & Hospital, Lucknow, India.
B B
BB
Lal
D000328:Adult; D015415:Biomarkers; D003715:Dengue / Q000150:complications / Q000473:pathology*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D012164:Retinal Diseases / Q000209:etiology / Q000473:pathology*; D012166:Retinal Hemorrhage / Q000473:pathology; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications; D055815:Young Adult
D015415:Biomarkers
Dengue; retinal abnormalities; thrombocytopenia; viral