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[登革热的眼底表现]

[The ocular fundus findings in dengue fever].

作者信息

Wen K H, Sheu M M, Chung C B, Wang H Z, Chen C W

出版信息

Gaoxiong Yi Xue Ke Xue Za Zhi. 1989 Jan;5(1):24-30.

PMID:2733064
Abstract

From September to December of 1988, 24 cases of clinical diagnosed dengue fever accompanied by visual disturbances were studied. A detailed history and a detailed ocular examination including visual acuity, slit lamp examination, fundus examination through dilated pupil and fluorescein angiography were conducted. In some cases, Amsler grid, visual field, visual evoked potential and color vision test were also evaluated. The chief complaints of these 24 patients were blurred vision, central scotoma, floaters, photophobia and halo vision. The intervals between onset of fever and awareness of blurred vision were 2 to 15 days with an average of 7.26 days. The ocular fundus changes included macular hemorrhage, retinal hemorrhage, maculopathy, Roth's spot, diffuse retinal edema, peripapillary hemorrhage vitreous cells and blurring optic disc. The fluorescein angiographic findings included poor choroidal flushing, delayed disc filling, disc extravasation, block fluorescence, capillary obliteration, non filling of macular network, capillary leakage and window defect. Seventeen cases (30 eyes) were followed-up for 2 weeks to 3 months. Visual recovery was good in most of the cases. However, 2 cases (4 eyes) showed poor visual outcome. In this series studied, the principle ocular fundus change caused by dengue fever was macular hemorrhage. This may be due to the capillary changes near the macular area. But in some of the cases, the direct viral invasion and/or indirect changes of the optic nerve, the retinal pigment epithelium or photoreceptors should be considered.

摘要

1988年9月至12月,对24例临床诊断为登革热并伴有视觉障碍的患者进行了研究。详细询问了病史,并进行了详细的眼部检查,包括视力、裂隙灯检查、散瞳眼底检查和荧光素血管造影。部分病例还评估了Amsler方格表、视野、视觉诱发电位和色觉测试。这24例患者的主要症状为视力模糊、中心暗点、飞蚊症、畏光和光晕视觉。发热至出现视力模糊的间隔时间为2至15天,平均为7.26天。眼底改变包括黄斑出血、视网膜出血、黄斑病变、Roth斑、弥漫性视网膜水肿、视乳头周围出血、玻璃体细胞和视盘模糊。荧光素血管造影表现包括脉络膜充盈不良、视盘充盈延迟、视盘渗漏、荧光遮挡、毛细血管闭塞、黄斑网络不充盈、毛细血管渗漏和窗样缺损。17例(30只眼)进行了2周至3个月的随访。大多数病例视力恢复良好。然而,2例(4只眼)视力预后较差。在本研究系列中,登革热引起的主要眼底改变是黄斑出血。这可能是由于黄斑区附近的毛细血管变化所致。但在某些病例中,应考虑病毒对视神经、视网膜色素上皮或光感受器的直接侵袭和/或间接改变。

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