Ocular findings in patients with Crimean-Congo hemorrhagic fever.

PURPOSE

To describe ocular findings of patients with Crimean-Congo hemorrhagic fever (CCHF).

DESIGN

Prospective, interventional, consecutive case series.

METHODS

This study was conducted in Sivas, a city located in the central Anatolia, between July 1 and August 31, 2007. Confirmed CCHF patients were enrolled in the study and underwent ocular examination during hospitalization.

RESULTS

Nineteen confirmed CCHF patients were included in this study. All patients were classified into 2 groups in terms of disease severity (severe vs nonsevere), according to the Swanepoel predictive criteria. Fourteen patients (73.7%) were classified as "nonsevere," and the remaining 5 patients (26.3%) were classified as "severe" in this study. One patient having severe disease died. Ocular findings were present in 14 patients (73.7%) and none of the patients presented any visual complaints. Ocular examination revealed that 7 patients (36.8%) had only bilateral multiple subconjunctival hemorrhage, and 2 patients (10.5%) (1 bilateral, 1 unilateral) had retinal hemorrhage. Five patients (26.3%) had subconjunctival hemorrhage and retinal hemorrhage. Follow-up examination 1 month later showed complete resorption of the subconjunctival hemorrhage and retinal hemorrhage. There was a statistically significant difference between patients with ocular findings and patients without ocular findings for prothrombin time (P = .011). There was no evidence of uveitis, retinal edema, sheathing of retinal vessels, or intravitreal hemorrhage in our patients.

CONCLUSION

From the small sample study, CCHF caused a mild form of ocular disease. CCHF must be considered when subconjunctival or superficial retinal hemorrhages are seen in association with fever in endemic areas.