Arthropod Vector-Borne Uveitis in the Developing World

New Infectious Etiologies for Posterior Uveitis

“…Most human infections are subclinical (80%) or manifest as febrile illness (20%) [1,2,3]. Severe neurological disease was reported to occur in less than 1% of patients and was frequently associated with advanced age and diabetes [3]. The diagnosis is confirmed by the detection of IgM antibody in serum or cerebrospinal fluid and/or by PCR [4].…”

“…Most patients with chorioretinitis are above 50 years of age and have diabetes mellitus, with a substantial proportion of them exhibiting associated diabetic retinopathy [9]. Although multifocal chorioretinitis is the most common ocular manifestation of WNV infection, other manifestations have been described, including retinal hemorrhages, focal or diffuse retinal vascular sheathing, vascular leakage, occlusive vasculitis, zones of atrophy and mottling of retinal pigment epithelium (RPE), macular edema, and optic neuritis [1,2,3,5,6]. Ocular disease associated with WNV infection usually has a self-limited course, and visual acuity returns to baseline in most patients [5].…”

“…The virus is widely distributed in Africa, Europe, Australia and Asia, and since 1999 it has spread rapidly throughout the Western hemisphere, including the United States, Canada, Mexico and the Caribbean and into parts of Central and South America [1,2,3]. Most human infections are subclinical (80%) or manifest as febrile illness (20%) [1,2,3]. Severe neurological disease was reported to occur in less than 1% of patients and was frequently associated with advanced age and diabetes [3].…”

“…WNV infection is a zoonotic disease caused by a single-stranded RNA flavivirus and transmitted to human by a mosquito vector (type Culex ) with wild birds serving as its reservoir [1,2,3]. The virus is widely distributed in Africa, Europe, Australia and Asia, and since 1999 it has spread rapidly throughout the Western hemisphere, including the United States, Canada, Mexico and the Caribbean and into parts of Central and South America [1,2,3].…”

“…Systemic disease may range from mild febrile illness to severe, potentially lethal systemic involvement. Specific viral and bacterial arthropod vector-borne infections have been recently associated with posterior uveitis and other ocular manifestations [1,2,3]. They include viral diseases, namely West Nile virus (WNV) infection, Rift Valley fever (RVF), Dengue fever (DF), Chikungunya, and rickettsioses.…”