A.NG1, H MI1, SL HO1, SC TEOH1, R AGRAWAL1
Tan Tock Seng Hospital1
Southeast Asia has one of the highest incidence of dengue fever worldwide. Significant ocular manifestations of degnue fever include macular edema, retinal hemorrhages, retinal vasculitis, exudative retinal detachment, and uveitis. This study aims to identify the characteristics, treatments, and visual outcomes of dengue uveitis at the National Healthcare Group Eye Institute, Tan Tock Seng Hospital (TTSH).
We retrospectively analysed all consecutive dengue uveitis patients from 2004 to 2015. The Ocular Autoimmune Systemic Inflammatory and Infectious Study (OASIS) database was used. All patients underwent a standardized clinical history, systemic review, ophthalmological examination, and laboratory tests. When necessary, further ancillary tests were performed.
The most common ocular symptom was that of blurring of vision, followed by floaters metamorphopsia, scotoma.
Majority presented with either a posterior uveitis or retinal vasculitis. A range of clinical features were reported with vasculitis, diagnosed clinically and on FFA, the most common.
There were a variety of treatment methods, from close observation for spontaneous improvement, to the use of high dose systemic steroids. All patients regained a final visual acuity of at least 6/9, apart from one who had a final visual acuity of 6/12.
Dengue uveitis has significant implications to the patient’s long-term vision. Not all underwent FFA and we believe we are underestimating the true number of vasculitis. Most were treated with close observation alone and some were given corticosteroids with good outcomes. We believe corticosteroids must be considered in severe disease. Persistent scotoma is experienced by patients and should be investigated in future studies.