The Eye and the Chikungunya Virus

Abstract

Ocular involvement in chikungunya virus (CHIKV) infection can be present as mild and vision-threatening ocular complications with unilateral or bilateral compromise in both gender and all ages. Precise prevalence and incidence are unknown, but ocular involvement of CHIKV infection is uncommon. Anterior uveitis is the most common syndromic manifestation; nevertheless the infection could manifest posterior segment repercussion, such as retinitis which is the other most usual clinical manifestation. At the beginning of the systemic disease, main ophthalmologic symptoms are conjunctival injection, retro-ocular pain, and photophobia. Ocular pathogenesis of CHIKV infection is not totally clarified; however, findings related to an immune dysregulation and proinflammatory processes are the most accepted theories. The diagnosis of CHIKV is based on polymerase chain reaction, virus isolation, or detection of viral antigens which should be used before the eighth day of systemic illness. After 8 days, chikungunya serologic tests such as IgM ELISA/rapid tests or IgG paired must be used. Actual management is focused according to the clinical context of each patient. While in most instances recovery of vision to normal occurs, CHIKV infection can result in blindness, the visual prognosis depends on various factors, but the common one is the early onset of corticosteroid treatment.

An imaging-based treatment algorithm for posterior focal retinitis

“…Though periocular and systemic steroids have been used successfully for posterior segment involvements associated with dengue fever, chikungunya fever, and Rift valley fever, many of such lesions resolve spontaneously with time. 33 – 35 Thus, there is an unmet need for large randomized control trials evaluating the role of systemic steroid and systemic antiviral in such cases.…”

Growth in chikungunya virus-related research in ASEAN and South Asian countries from 1967 to 2022 following disease emergence: a bibliometric and graphical analysis

“…The term "chikungunya", which originated from the Makonde language of Tanzania, is attributed to the "bending posture" of patients infected with the chikungunya virus who experience excruciating pain in the joints, which might persist for months [1,[12][13][14]. Apart from severe muscular and joint pain, chikungunya virus infections are also accompanied by headaches, rashes, photophobia, and fever [15][16][17][18]. Prolonged chikungunya virus infection may trigger adverse effects, including brain inflammation, damage to optic nerves, injury to the spinal cord, Guillain-Barré syndrome, heart muscle inflammation, hepatitis, a renal lesion, or even death [19][20][21][22][23][24].…”