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登革热的眼部并发症——急性闭角型青光眼:综述

Acute Angle-Closure Glaucoma as an Ocular Complication of Dengue Fever: A Comprehensive Review.

作者信息

Al-Essa Aiad

机构信息

Department of Ophthalmology, Maharishi Markandeshwar University, Solan, IND.

出版信息

Cureus. 2025 Apr 11;17(4):e82119. doi: 10.7759/cureus.82119. eCollection 2025 Apr.

Abstract

Dengue fever, a rapidly spreading global epidemic, ranks among the most frequently reported viral infections worldwide, typically presenting with systemic symptoms such as fever, headache, and rash. Although generally linked to systemic issues, dengue infection can also lead to uncommon ocular complications, such as acute angle-closure glaucoma (AACG), which poses a threat to sight. This review focuses on the alterations in the anterior chamber angle and the subsequent development of glaucoma after dengue infection. Prompt and precise diagnosis, aided by essential diagnostic tools like intraocular pressure (IOP) measurement, gonioscopy, and advanced imaging methods, is essential for effective management. The initial treatment typically includes osmotic agents, carbonic anhydrase inhibitors, and topical glaucoma medications, with Nd:YAG (neodymium-doped yttrium aluminum garnet) laser iridotomy being the definitive treatment option. The review emphasizes the importance of long-term monitoring to assess ocular outcomes and prevent relapse. While AACG occurrence in dengue patients is rare, healthcare providers in endemic areas must stay alert for ocular symptoms in dengue patients presenting with vision problems. Preventing irreversible vision loss demands increased vigilance, early diagnosis, and timely treatment. Additionally, the review advocates for more clinical research and the creation of refined diagnostic protocols to tackle this rare but severe complication.

摘要

登革热是一种迅速蔓延的全球流行病,是全球报告最为频繁的病毒感染之一,通常表现为发热、头痛和皮疹等全身症状。虽然登革热感染一般与全身问题有关,但它也可能导致罕见的眼部并发症,如急性闭角型青光眼(AACG),这对视力构成威胁。本综述聚焦于登革热感染后前房角的改变以及随后青光眼的发生。借助眼压(IOP)测量、前房角镜检查和先进成像方法等重要诊断工具进行及时、准确的诊断,对有效治疗至关重要。初始治疗通常包括渗透剂、碳酸酐酶抑制剂和局部青光眼药物,钕:钇铝石榴石(Nd:YAG)激光虹膜切开术是最终的治疗选择。该综述强调了长期监测以评估眼部预后和预防复发的重要性。虽然登革热患者中发生AACG的情况很少见,但流行地区的医疗服务提供者必须对出现视力问题的登革热患者的眼部症状保持警惕。预防不可逆的视力丧失需要提高警惕、早期诊断和及时治疗。此外,该综述倡导开展更多临床研究并制定完善的诊断方案,以应对这种罕见但严重的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b18/12066814/ab50623ac379/cureus-0017-00000082119-i01.jpg

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