Wani Vivek, Tenagi Arvind, Bubanale Shivanand C, B K Bhagyajyothi, Mutalik Deepashri, Warad Chethana
Department of Ophthalmology, Jawaharlal Nehru Medical College, Belagavi, IND.
Cureus. 2024 Jan 29;16(1):e53162. doi: 10.7759/cureus.53162. eCollection 2024 Jan.
Background Post-fever retinitis (PFR) is reported two to six weeks after fever and affects one or both eyes. Rickettsial fever is one of the most common causes of PFR. This study aimed to report the clinical features and treatment outcomes of PFR cases with a positive Weil-Felix test. Methodology In this study, we collected demographic data, fever details, eye symptoms, ocular examination findings, optical coherence tomography (OCT) and fundus fluorescein angiography findings, laboratory findings, and length of follow-up of consecutive PFR cases with a positive Weil-Felix test. All cases were treated with oral doxycycline and prednisolone. Final best-corrected visual acuity (BCVA) and ocular examination findings were recorded. Visual field examination and follow-up OCT results were noted if available. Results A total of nine patients (eight males) with a mean age of 39.1 years with fever before ocular symptoms and positive Weil-Felix test were included. Six patients had bilateral disease. The mean initial and final BCVA in the affected eyes was 1.16 and 0.35 logMAR units, respectively (p < 0001). All 15 eyes had typical white retinitis patches and retinal hemorrhages which resolved after treatment. OCT showed hyperreflectivity and inner retinal disorganization over retinitis patches. White subretinal lines were noted in three patients and retinal nerve fiber bundle defect with corresponding visual field defect was seen in one eye. Conclusions In this study, PFR due to rickettsia infections has been reported from our region for the first time. Hence, eye specialists in the region should be aware of this entity.
发热后视网膜病变（PFR）在发热后两到六周被报道，可累及单眼或双眼。立克次体热是PFR最常见的病因之一。本研究旨在报告Weil-Felix试验阳性的PFR病例的临床特征和治疗结果。方法：在本研究中，我们收集了连续的Weil-Felix试验阳性的PFR病例的人口统计学数据、发热详情、眼部症状、眼科检查结果、光学相干断层扫描（OCT）和眼底荧光血管造影结果、实验室检查结果以及随访时间。所有病例均接受口服强力霉素和泼尼松龙治疗。记录最终的最佳矫正视力（BCVA）和眼科检查结果。如有视野检查和随访OCT结果也予以记录。结果：共纳入9例患者（8例男性），平均年龄39.1岁，眼部症状出现前有发热且Weil-Felix试验阳性。6例患者为双侧病变。患眼的平均初始和最终BCVA分别为1.16和0.35 logMAR单位（p < 0.001）。所有15只眼均有典型的白色视网膜病灶和视网膜出血，治疗后消退。OCT显示视网膜病灶处高反射性和视网膜内层结构紊乱。3例患者可见白色视网膜下线条，1只眼可见视网膜神经纤维束缺损及相应的视野缺损。结论：在本研究中，我们地区首次报道了由立克次体感染引起的PFR。因此，该地区的眼科专家应了解这一疾病。
