Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, Telangana, India.
The Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2021 Mar;69(3):617-622. doi: 10.4103/ijo.IJO_1588_20.
To describe a series of sight-threatening ocular and adnexal involvement associated with dengue hemorrhagic fever and their treatment options.
Retrospective, interventional, non-comparative case series. Medical records of patients who presented with ocular symptoms attributed to dengue hemorrhagic fever were reviewed. Demography, presenting features, and treatment outcomes were recorded. Outcome measures assessed included globe salvage, vision salvage, and visual improvement. The outcome was deemed as favorable if vision salvage was possible and unfavorable if the vision was lost.
Twenty-nine eyes of 23 patients were included. Bilateral ocular involvement was seen in 6 (26%) patients. The mean age was 37.62 ± 18.68 years (range: 14 to 81 years). Coexistent diabetes mellitus and enteric fever were present in three patients. History of blood transfusion was present in nine (40%) and thrombocytopenia in eight (35%) patients at the time of presentation with ocular complaints. Presenting features included endophthalmitis in 11 (38%), panophthalmitis in 10 (35%), orbital cellulitis with panophthalmitis in four (14%), isolated corneal or scleral melt in three (10%), and orbital hemorrhage with panophthalmitis in one (3%) patient. Globe salvage was achieved in 21/29 eyes (72.4%), vision salvage in 6/29 eyes (20.68%), and improvement in visual acuity was noted in 5/29 eyes (17.24%). Logistic regression analysis revealed no significant effect of any clinical-microbiological factors on globe salvage, vision salvage, and visual improvement. However, visual improvement and globe salvage were possible in eyes that underwent early endoscopic vitrectomy.
Dengue fever can present with sight-threatening ocular and adnexal inflammation resulting in endophthalmitis and panophthalmitis, orbital cellulitis, corneal and scleral melt, and orbital hemorrhage. Early vitrectomy may improve vision and globe salvage in cases with significant vitritis.
描述一系列与登革出血热相关的威胁视力的眼部和附属器受累及其治疗选择。
回顾性、干预性、非对照病例系列研究。对表现出与登革出血热相关的眼部症状的患者的病历进行了回顾。记录了人口统计学、临床表现和治疗结果。评估的结果测量包括眼球保存、视力保存和视力改善。如果视力保存成为可能，则认为结果是有利的，如果视力丧失，则认为结果是不利的。
23 例患者的 29 只眼纳入研究。6 例（26%）患者存在双眼眼部受累。平均年龄为 37.62 ± 18.68 岁（范围：14 至 81 岁）。3 例患者同时患有糖尿病和肠热病。9 例（40%）患者在出现眼部症状时存在输血史，8 例（35%）患者存在血小板减少症。主要表现为眼内炎 11 例（38%）、全眼炎 10 例（35%）、眶蜂窝织炎伴全眼炎 4 例（14%）、孤立性角膜或巩膜溶解 3 例（10%）、眶内出血伴全眼炎 1 例（3%）。21/29 只眼（72.4%）眼球得以保存，6/29 只眼（20.68%）视力得以保存，5/29 只眼（17.24%）视力得到改善。逻辑回归分析显示，任何临床微生物因素对眼球保存、视力保存和视力改善均无显著影响。然而，在早期进行内镜玻璃体切除术的眼中，视力改善和眼球保存是可能的。
登革热可引起威胁视力的眼部和附属器炎症，导致眼内炎和全眼炎、眶蜂窝织炎、角膜和巩膜溶解以及眶内出血。在存在明显眼内炎的情况下，早期玻璃体切除术可能会改善视力和保存眼球。
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