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登革热的眼部表现。

Ocular manifestations of dengue.

机构信息

Vitreo-Retinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

出版信息

Curr Opin Ophthalmol. 2019 Nov;30(6):500-505. doi: 10.1097/ICU.0000000000000613.

Abstract

PURPOSE OF REVIEW

There are an increasing number of publications related to dengue ophthalmic manifestations and multimodality imaging related to dengue. This review summarizes the current literature, describe ocular manifestations, current using of ocular imaging/investigations, and management of ocular dengue.

RECENT FINDINGS

Ocular manifestations of dengue can be present in many stages of dengue fever including after the resolution of systemic disease. Most cases of ocular dengue will exhibit an improvement in vision spontaneously over time. Multimodal imaging such as optical coherence tomography, optical coherence tomography angiography, near-infrared imaging, and microperimetry plays an important role in the diagnosis, follow-up, quantitative measure, and help to understand the disease progression.

SUMMARY

Dengue fever can lead to a variety of ocular manifestations. The mechanisms underlying dengue-related ocular complications remain unclear. Immune-mediated mechanisms and direct viral invasion are thought to play an important role. Ophthalmologists should carefully assess patients with dengue-related ophthalmic disease because some patients may have poor visual acuity and exhibit refractoriness to treatment. Treatment with systemic corticosteroids may benefit those patients with poor presenting visual acuity, progressive ocular symptoms, and lesions involving the optic nerve and/or threatening the macula.

摘要

目的综述

与登革热眼部表现和与登革热相关的多模态成像相关的出版物数量不断增加。本综述总结了目前的文献,描述了眼部表现、目前使用的眼部成像/检查以及眼部登革热的治疗方法。

最近的发现

登革热的眼部表现可出现在登革热发热的多个阶段,包括全身疾病缓解后。大多数眼部登革热病例的视力会随着时间的推移自然恢复。多模态成像,如光学相干断层扫描、光学相干断层扫描血管造影、近红外成像和微视野计,在诊断、随访、定量测量和帮助了解疾病进展方面发挥着重要作用。

总结

登革热可引起多种眼部表现。登革热相关眼部并发症的发病机制尚不清楚。免疫介导机制和病毒直接侵袭被认为发挥了重要作用。眼科医生应仔细评估与登革热相关的眼部疾病患者,因为一些患者可能视力较差,并且对治疗反应不佳。全身性皮质类固醇治疗可能对那些视力差、眼部症状进行性加重以及视神经受累和/或黄斑受威胁的患者有益。

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