Department of Ophthalmology, Oulu University Hospital, FIN-90029 OYS, Finland.
Br J Ophthalmol. 2011 Apr;95(4):559-62. doi: 10.1136/bjo.2010.185413. Epub 2010 Aug 1.
To appraise the ocular manifestations of Puumala hantavirus evoked haemorrhagic fever with renal syndrome nephropathia epidemica (NE) and to clarify the mechanisms of ocular changes in the largest series of patients examined to date.
92 eyes of 46 patients with serologically proven NE were examined during the acute phase and after clinical recovery. Ocular symptoms were recorded, and visual acuity, refraction, intraocular pressure and ocular dimensions were evaluated.
88% of the patients experienced decreased intraocular pressure (IOP) (p<0.001), 87% reduced visual acuity, 87% conjunctival chemosis, 82% thickening of the lens (p<0.05), 78% myopic shift (p<0.001), 64% shallowing of the anterior chamber (p<0.05) and 52% shallowing of vitreous length (p<0.05) during the acute phase compared with that measured after clinical recovery. In all, 70% of the patients reported ocular symptoms.
Ocular symptoms and disturbances are common in acute NE, and the symmetry of the ocular changes reflects the systemic nature of the disease. A decrease in IOP and myopic shift mainly due to thickening of the lens are evident in acute disease. The myopic shift only partially explains the visual disturbances supporting the possible multifactorial origin of the ocular findings in patients with NE.
评估普马拉汉坦病毒引起的肾综合征出血热（HFRS）的眼部表现，并阐明迄今为止检查的最大系列患者中眼部变化的机制。
对 46 例经血清学证实的 HFRS 患者的 92 只眼在急性期和临床康复后进行检查。记录眼部症状，并评估视力、屈光度、眼压和眼球尺寸。
88%的患者出现眼压降低（IOP）（p<0.001），87%的患者视力下降，87%的患者出现结膜水肿，82%的患者晶状体增厚（p<0.05），78%的患者出现近视漂移（p<0.001），64%的患者前房变浅（p<0.05），52%的患者玻璃体长度变浅（p<0.05），与临床康复后测量的结果相比。共有 70%的患者报告了眼部症状。
眼部症状和障碍在急性 HFRS 中很常见，眼部变化的对称性反映了疾病的全身性。在急性疾病中，眼压降低和近视漂移主要是由于晶状体增厚引起的。近视漂移仅部分解释了视觉障碍，支持 NE 患者眼部发现可能存在多因素起源。
