Foveolitis associated with dengue fever: A case series

Background: Dengue fever (DF), a viral infection caused by dengue virus, is characterized by fever, headache, muscle and joint pains. Approximately 50-100 million people are infected annually. Ocular manifestations during DF are uncommon and include intraretinal hemorrhages and cotton wool spots; manifestations predominantly characterized by foveal involvement have not been described before in DF or any other retinopathies. We describe the clinical features of a series of patients with DF-associated foveolitis. Methods: A retrospective review of patients with maculopathy associated with DF was conducted. Patients found to have a yellow-orange lesion at the fovea, supported by a typical optical coherence tomography ( OCT) finding of disruption of the outer neurosensory retina, were analyzed. Results: Ten eyes of 6 patients were studied. The mean age was 19.8 years. The mean presenting best corrected visual acuity was 6/45 ( range of 6/7.5 to counting fingers). Fundus examination revealed a yellow-orange lesion at the fovea which corresponded to outer neurosensory retina disruption on OCT. Multifocal electroretinography showed decreased foveal and parafoveal responses. Treatment was variable, depended on visual acuity and ranged from observation to immunosuppression. Conclusion: Foveolitis may be associated with DF. OCT is a useful tool for the diagnosis and monitoring of progression of this condition. Copyright (C) 2008 S. Karger AG, Basel.