Malek Mohammad Ibn Abdul, Niyonzima Jean Claude, Pathan Md Arif Hayat Khan, Rahman Md Mostafizur
Vitreo-Retina and Uvea, Ispahani Islamia Eye Institute and Hospital, Dhaka, BGD.
Cureus. 2022 Jun 13;14(6):e25916. doi: 10.7759/cureus.25916. eCollection 2022 Jun.
Although rare, dengue fever-associated ocular manifestations are a valid cause of visual impairment. Clinicians usually have a dilemma between vitrectomy and medical management if there is an associated vitreous hemorrhage. Vitrectomy has been rarely reported previously in the management of vitreous hemorrhage secondary to dengue fever. We report a case of a young adult who presented with bilateral vitreous hemorrhages. The diagnosis of dengue was confirmed by serology and a typical epidemiological context. The patient presented already having undergone yttrium aluminum garnet (YAG) laser hyaloidotomy for preretinal hemorrhage in the other eye, with a subsequent vitreous spread of the hemorrhage. Vitrectomy with internal limiting membrane (ILM) peeling was performed for the affected eye and the visual acuity was fully regained after a few weeks. Dengue fever can present with dense or sub-ILM hemorrhages. In our case, the vision quickly recovered after vitrectomy and ILM peeling. We, therefore, recommend early vitrectomy in cases with vitreous hemorrhage associated with sub-ILM involvement so as not to delay visual recovery.
尽管罕见，但登革热相关的眼部表现是导致视力损害的一个切实原因。如果伴有玻璃体出血，临床医生在玻璃体切除术和药物治疗之间通常会左右为难。此前，关于登革热继发玻璃体出血的治疗，玻璃体切除术的报道很少。我们报告一例年轻成年人双侧玻璃体出血的病例。通过血清学检查及典型的流行病学背景确诊为登革热。该患者另一只眼已因视网膜前出血接受了钇铝石榴石（YAG）激光玻璃体切割术，随后出血蔓延至玻璃体。对患眼进行了玻璃体切除术并剥除内界膜（ILM），几周后视力完全恢复。登革热可出现致密或内界膜下出血。在我们的病例中，玻璃体切除术和内界膜剥除术后视力迅速恢复。因此，我们建议对于伴有内界膜受累的玻璃体出血病例尽早进行玻璃体切除术，以免延误视力恢复。
