Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
Department of Ophthalmology, Military Hospital Queen Astrid, Brussels, Belgium.
Ocul Immunol Inflamm. 2024 Sep;32(7):1374-1379. doi: 10.1080/09273948.2023.2246549. Epub 2023 Aug 16.
To describe the clinical and epidemiological characteristics of the first epidemic of Rift Valley Fever retinitis in Rwanda and to report novel imaging findings and a possible role for corticosteroids.
Retrospective analysis of all patients who presented with presumed Rift Valley Fever retinitis at the Rwanda Charity Eye Hospital over a period of 4 months in 2022. Multimodal images are reviewed including optical coherence tomography, fluorescein angiography, color, infrared, red-free, and autofluorescence photography.
The newly identified arciform hyporeflective pattern on infrared imaging was present in 100% of patients. Out of 9 patients treated with oral corticosteroids, 7 (78%) experienced a visual acuity increase of at least 0.2 during follow-up, in comparison to only 4 (28%) out of 14 of untreated patients. Out of four patients treated with a subtenon corticosteroid injection, only one (25%) reached this threshold. Post-hoc pairwise comparison with Bonferroni correction revealed a significant difference in average visual acuity improvement ( = 0.034) between patients receiving oral corticosteroids (0.35 ± 0.07) versus no treatment (0.11 ± 0.04).
The identified arciform hyporeflective pattern on infrared imaging appears to be characteristic of Rift Valley Fever retinitis and should be known to clinicians working in endemic regions. Compared to a historical cohort and to untreated patients in this non-randomized study, there appears to be a benefit of treatment with oral corticosteroids.
描述卢旺达首次裂谷热视网膜炎流行的临床和流行病学特征，并报告新的影像学发现和皮质类固醇的可能作用。
回顾性分析 2022 年 4 个月内在卢旺达慈善眼科医院就诊的疑似裂谷热视网膜炎患者。回顾了包括光相干断层扫描、荧光素血管造影、彩色、近红外、红色自由和自发荧光摄影在内的多种模态图像。
在 100%的患者中均存在新发现的红外成像弓形低反射模式。在接受口服皮质类固醇治疗的 9 名患者中，有 7 名（78%）在随访期间视力至少提高了 0.2，而未接受治疗的 14 名患者中只有 4 名（28%）达到了这一水平。在接受球后皮质类固醇注射治疗的 4 名患者中，只有 1 名（25%）达到了这一水平。经 Bonferroni 校正的事后两两比较显示，接受口服皮质类固醇治疗的患者（0.35±0.07）与未治疗的患者（0.11±0.04）平均视力改善差异有统计学意义（ = 0.034）。
在红外成像上发现的弓形低反射模式似乎是裂谷热视网膜炎的特征，应让在流行地区工作的临床医生知晓。与历史队列和本非随机研究中未接受治疗的患者相比，口服皮质类固醇治疗似乎有获益。
