Mahendradas Padmamalini, Ranganna Shylaja K, Shetty Rohit, Balu Ramgopal, Narayana Kannan M, Babu Rajesh B, Shetty Bhujang K
Uveitis and Ocular Immunology Services, Super Speciality Eye Hospital and Postgraduate Institute of Ophthalmology, Narayana Nethralaya, Bangalore, India.
Ophthalmology. 2008 Feb;115(2):287-91. doi: 10.1016/j.ophtha.2007.03.085. Epub 2007 Jul 12.
To report ocular manifestations associated with chikungunya.
Retrospective, nonrandomized, observational case series.
Nine chikungunya patients with ocular involvement.
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.
Characteristics, frequency, and locations of ocular lesions found in the participants.
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.
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.
报告与基孔肯雅热相关的眼部表现。
回顾性、非随机、观察性病例系列。
9例有眼部受累的基孔肯雅热患者。
纳入2006年9月至2006年10月出现眼部症状的所有基孔肯雅热感染患者。通过检测所有患者血清中的基孔肯雅免疫球蛋白M抗体确诊感染。所有患者均接受眼科检查，包括眼底照相、眼底荧光血管造影、角膜后沉着物共聚焦显微镜检查和光学相干断层扫描。记录并列表显示阳性眼部变化。
参与者中发现的眼部病变的特征、频率和部位。
9例患者有眼部病变；1例为结节性巩膜炎，5例表现为急性虹膜睫状体炎，3例有视网膜炎。在出现眼部表现前4至12周，所有这些患者均有发热。虽然虹膜睫状体炎没有诊断发热的特异性变化，但视网膜变化与病毒性视网膜炎一致。所有患者感染后视力恢复相对良好。
虹膜睫状体炎和视网膜炎似乎是与基孔肯雅热相关的最常见眼部表现，临床病程通常为良性。较少见的眼部病变包括巩膜炎。所有患者对治疗反应良好，视力得以保留。据我们所知，尚未有与基孔肯雅热感染相关的类似眼部表现的报道。在对提示病毒感染特征的虹膜睫状体炎和视网膜炎进行鉴别诊断时，在疫情流行地区应考虑基孔肯雅热相关眼部变化这一情况。
