Recurrent bilateral dengue maculopathy following sequential infections with two serotypes of dengue virus

Abstract

Sir, Recurrent bilateral dengue maculopathy following sequential infections with two serotypes of dengue virus Dengue fever (DF) by any one of the four serotypes (DEN-1 through -4) produces life-long immunity against re-infection by that same serotype but only temporary and partial protection against other serotypes.

Ophthalmic Complications of Dengue Fever: a Systematic Review

“…Bilateral blot hemorrhages in the macula of four patients were the only ocular sign associated with dengue fever in the series by Chlebicki et al [8]. Vascular sheathing [6, 11, 28, 31] and vasculitis [6, 10, 20, 24] were often found in association with macular hemorrhage.…”

“…Metamorphopsia was reported in six patients [8, 24, 31] and micropsia in four patients [20, 33]. Impairment of color vision had been reported in patients with optic neuropathy [24] and maculopathy [5, 29].…”

“…The three patterns of macular edema on OCT include type 1, which is diffuse edema, type 2, which is cystoid edema, and type 3, which is cystic foveolitis. There are also isolated case reports of patients with dengue-related macular edema [5, 17, 24, 31]. …”

“…Vascular occlusions were reported in four studies and mainly consisted of vein occlusions [24, 27, 28, 31]. Only one out of the four studies reported arterial occlusion of the superotemporal macular branch [27].…”

“…Fundus fluorescein angiography (FFA) demonstrated mainly vascular occlusion or leakage, and has aided in the diagnosis of vein occlusions [11, 31] and vasculitis [24, 30, 31]. In a study of 41 patients (71 eyes) with dengue-related ocular signs and symptoms, FFA picked up venular occlusion in 25% of eyes and vascular (arteriolar/venular) leakage in 16% of eyes [11].…”