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2020 年留尼汪岛登革热流行期间的眼部并发症:病例系列及文献复习。

Ophthalmic complications during the dengue epidemic in Reunion Island in 2020: a case series and review of the literature.

机构信息

Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France.

Santé Publique France, Océan Indien, Saint Denis, La Réunion, France.

出版信息

BMC Infect Dis. 2023 Aug 2;23(1):506. doi: 10.1186/s12879-023-08432-4.

Abstract

INTRODUCTION

Dengue is an arboviral disease transmitted by the dengue virus, whose vectors are Aedes aegypti and Aedes albopictus. The acute phase with its cohort of well-known symptoms is usually spontaneously favorable. Since 2020 in Reunion Island, a new symptom has appeared: the ocular damage of dengue fever, which has already been described in South Asia and South-East Asia. We therefore decided to describe the clinical, biological, ophthalmological, therapeutic, and outcomes of patients with ocular manifestations during dengue fever in Reunion Island in 2020.

PATIENTS AND METHODS

This was a retrospective observational study. Patients were included from January 2020 to August 2020 and then reassessed by teleconsultation 1 year later. The patients were identified from the French public health surveillance network by all ophthalmologists on the island. Medical data were collected directly from medical records.

RESULTS

Twenty-eight patients were included. The mean age was 41.9 years. Ocular involvement occurred approximately 9.2 days after the onset of dengue symptoms. The main symptoms were scotoma (71.4%) and sudden decrease of visual acuity (39.2%). Eighteen patients (64.2%) had macular involvement. Fourteen patients were treated with oral or intravenous corticosteroids. Twenty-two (78.5%) patients were evaluated by telephone one year later. Scotoma and decreased visual acuity persisted in 15 patients. Thirteen patients (59%) were bothered by night driving, 32% of patients had reading difficulties and 27% of patients became sensitive to prolonged exposure to screens.

CONCLUSION

Ocular complications of dengue require early and collegial management to limit the risk of long-term sequelae. Further studies on the characteristics and complications of dengue fever are needed to better understand this disease.

摘要

简介

登革热是一种由登革病毒引起的虫媒病毒病,其传播媒介为埃及伊蚊和白纹伊蚊。通常情况下,急性登革热伴有一系列众所周知的症状,会自行好转。自 2020 年以来,在留尼汪岛出现了一种新的症状:登革热眼部损伤,这种症状已在南亚和东南亚有所描述。因此,我们决定描述 2020 年留尼汪岛登革热患者眼部表现的临床、生物学、眼科、治疗和结局。

患者和方法

这是一项回顾性观察性研究。2020 年 1 月至 8 月期间,所有岛上的眼科医生通过法国公共卫生监测网络对患者进行了识别,并通过电话对患者进行了 1 年的重新评估。从医疗记录中直接收集患者的医疗数据。

结果

共纳入 28 例患者。平均年龄为 41.9 岁。眼部受累发生在登革热症状出现后约 9.2 天。主要症状为视野缺损(71.4%)和突发性视力下降(39.2%)。18 例(64.2%)患者存在黄斑受累。14 例患者接受了口服或静脉内皮质类固醇治疗。22 例(78.5%)患者在 1 年后通过电话进行了评估。15 例患者仍存在视野缺损和视力下降。13 例患者(59%)夜间开车困难,32%的患者阅读困难,27%的患者对长时间暴露在屏幕前敏感。

结论

登革热的眼部并发症需要早期进行协作管理,以降低长期后遗症的风险。需要进一步研究登革热的特征和并发症,以更好地了解这种疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b172/10394947/7f7d0bf8a6f2/12879_2023_8432_Fig1_HTML.jpg

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