Study of Ocular Manifestations in Patients Hospitalized with Dengue Fever

Abstract

Objective: To study the clinical spectrum of ocular manifestations in patients hospitalized with dengue fever during a dengue outbreak. Design: It is a cross-sectional observational study, designed to determine the prevalence of ocular signs and symptoms, in hospitalized dengue patients. It was conducted from the month of September to November 2017 (3 months) in a tertiary care hospital of Kolkata, India during a recent dengue outbreak. Methods: A detailed history was taken followed by a comprehensive eye examination which included BCVA assessment, Slit lamp based anterior segment examination was done followed by dilated fundoscopy with 90D slit lamp examination, the findings of which were confirmed by Indirect Ophthalmoscopy. Platelet counts and results of Dengue serological tests were also recorded. Result: 95 patients with dengue fever who were admitted in this hospital in the specified period were included in our study [1]. Dengue patients with ocular manifestations comprised 51.57%. Ocular pain was the most common symptom followed by redness and blurring of vision. The most common eye manifestation according to our study is Subconjunctival Haemorrhage (35.84%) followed by Retinal Hemorrhage (10.52%), Vascular Sheathing (10.52%), Cotton wool spots (9.47%), disc hyperamia (8.42%), and maculopathy (5.26%). Disc changes were noticed mainly in patients with previous history of dengue fever. Correlation of decrease in platelet count was significant with increase in subconjunctival hemorrhage, retinal hemorrhage, cotton wool spots and maculopathy (Pearsons' correlation coefficient). Conclusion:Patients hospitalized with dengue fever presented with a multitude of ocular symptoms and signs. The most common symptom being ocular pain whereas the most common sign being Subconjunctival hemorrhage. Intra retinal hemorrhages, maculopathy and cotton wool spots were the other most common signs all of which correlated with low platelet counts. Fundus examination can thus be used to prognosticate patients hospitalized with dengue fever.