Carrillo-Soto M A
Benemérito Comité Pro-Ciegos y Sordos de Guatemala, Hospital de Ojos y Oídos «Dr. Rodolfo Robles Valverde», Instituto de Ciencias de la Visión, Unidad de Retinovascular y Uveítis «Dr. Sigfrido Rodas», Ciudad de Guatemala, Guatemala.
Arch Soc Esp Oftalmol (Engl Ed). 2018 Jul;93(7):329-335. doi: 10.1016/j.oftal.2018.02.005. Epub 2018 Mar 23.
Describe the ocular findings of a case series of 8 patients with a diagnosis of dengue.
Review of clinical records and interviews with patients during outpatient visits, after informed consent was obtained and following the ethical standards of the Helsinki declaration. The patients were diagnosed with diagnosis by IgM / IgG dengue serology in whom ocular involvement was identified, between January and October 2017 in Retinal-vascular clinic of the "Dr. Rodolfo Robles Valverde Hospital", Guatemala.
The 8 patients, 5 men and 3 women from rural areas in Guatemala, were diagnosed with dengue by IgM / IgG serology with associated ocular involvement. The mean age was 32.3 years, with the oldest being 45 years old and the youngest being 20 years old. The ocular manifestations identified were, 4 neuroretinitis, 3 venous obstructions, 3 maculopathies, 2 serous detachments, 1 episcleritis, and 1 vasculitis. Two patients developed optic atrophy after resolving the neuroretinitis, and 1 developed peri-foveal scarring after the maculopathy. The ocular involvement was resolved in all patients after treatment, with an improvement in visual acuity, although in some cases damage to the visual field developed as a sequela of neuroretinitis.
It is necessary to consider dengue as an important differential diagnosis in an endemic country such as Guatemala. There are a large number of ocular manifestations due to direct involvement, as well as by an immune system reaction, and thus avoid considering the different ocular manifestations as idiopathic, or due to a different condition.
描述8例诊断为登革热患者的眼部检查结果。
在获得知情同意后，按照赫尔辛基宣言的伦理标准，回顾临床记录并在门诊期间对患者进行访谈。这些患者于2017年1月至10月在危地马拉“鲁道夫·罗伯斯·瓦尔韦德博士医院”视网膜血管诊所通过IgM/IgG登革热血清学诊断为登革热且伴有眼部受累。
这8例患者中，5例男性和3例女性来自危地马拉农村地区，通过IgM/IgG血清学诊断为登革热并伴有相关眼部受累。平均年龄为32.3岁，年龄最大的为45岁，最小的为20岁。所发现的眼部表现为4例神经视网膜炎、3例静脉阻塞、3例黄斑病变、2例浆液性视网膜脱离、1例巩膜炎和1例血管炎。2例患者在神经视网膜炎消退后出现视神经萎缩，1例患者在黄斑病变后出现黄斑中心凹周围瘢痕形成。所有患者经治疗后眼部受累情况均得到缓解，视力有所改善，尽管在某些情况下，神经视网膜炎的后遗症导致视野受损。
在危地马拉这样的流行国家，有必要将登革热视为重要的鉴别诊断。由于直接受累以及免疫系统反应，存在大量眼部表现，因此应避免将不同的眼部表现视为特发性或由其他不同病症引起。
