Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Eagle Eye Centre, Singapore; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
Surv Ophthalmol. 2015 Mar-Apr;60(2):106-14. doi: 10.1016/j.survophthal.2014.07.003. Epub 2014 Aug 12.
Dengue fever, a viral disease epidemic in some parts of the world, is of considerable international concern, with a growing incidence owing to developing urbanization, tourism, and trade. Ocular manifestations of dengue fever are uncommon, but of great significance. Proposed mechanisms include direct viral infection as well as immunologic phenomena. Common manifestations include subconjunctival, vitreous, and retinal hemorrhages; posterior uveitis; optic neuritis; and maculopathies such as foveolitis, hemorrhage, and edema. Main symptoms include blurring of vision, scotomata, metamorphopsia, and floaters. Diagnostic and monitoring investigations described included optical coherence tomography, fundus fluorescein and indocyanine green angiography, visual field analysis, and electrophysiologic tests. Management is based on clinical presentation and includes active surveillance as well as various anti-inflammatory and immunosuppressive therapies. There have been no prospective, randomized therapeutic trials, and it is unclear if the disease is self-limiting or if treatment is actually beneficial. Prognosis varies, ranging from full resolution to permanent vision loss despite intervention.
登革热是一种在世界某些地区流行的病毒性疾病，由于城市化、旅游和贸易的发展，发病率不断上升，引起了相当大的国际关注。登革热的眼部表现并不常见，但意义重大。其发病机制包括病毒直接感染和免疫现象。常见表现包括结膜下、玻璃体和视网膜出血；后葡萄膜炎；视神经炎；以及黄斑病变，如黄斑炎、出血和水肿。主要症状包括视力模糊、视野缺损、视物变形和眼前漂浮物。描述的诊断和监测检查包括光学相干断层扫描、眼底荧光素和吲哚青绿血管造影、视野分析和电生理检查。治疗基于临床表现，包括主动监测以及各种抗炎和免疫抑制治疗。目前尚无前瞻性、随机治疗试验，尚不清楚疾病是自限性的，还是治疗实际上是有益的。预后差异很大，从完全恢复到即使干预也会导致永久性视力丧失不等。
