West Nile virus infection and diplopia: a case report and review of literature

Dahal, Udip; Mobarakai, Neville; Sharma, Dikshya; Pathak, Bandana

doi:10.2147/ijgm.s42853

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…Multifocal chorioretinitis is the most frequent ocular manifestation of WNV infection. However, several ophthalmologic findings have been reported, including iridocyclitis, retinal vasculitis, macular edema, choroidal neovascularization, optic neuropathy, neuroretinitis, congenital chorioretinal scarring, ocular nerve palsy, and nystagmus secondary to encephalitis [ 5 , 11 , 12 ]. Excluding the most severe cases, West Nile chorioretinitis is considered to be a self-limiting pathology if retinal and choroidal complications do not occur, and patients can be watched without treatment.…”

Section: Discussionmentioning

confidence: 99%

Bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus infection: a case report

Valsecchi,

Veronese,

Roda

et al. 2024

BMC Ophthalmol

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Background To describe a case of bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus (WNV) infection in the absence of neurological involvement. Case presentation A 78-year-old Italian woman was admitted to our emergency department because she noticed blurry vision in both eyes. She did not report fever, fatigue, or neurological symptoms in the last few days. Multimodal imaging showed the presence of bilateral hyperfluorescent lesions with a linear distribution, that corresponded to hypocyanescent spots on indocyanine green angiography. Antibody serology showed the presence of IgM antibodies, IgG antibodies, and ribonucleic acid (RNA) for WNV. Magnetic resonance imaging (MRI) of the brain ruled out central nervous system involvement. Three months later, the patient reported spontaneous resolution of her symptoms and remission of the chorioretinal infiltrates. Conclusions In endemic areas, it is important to think of acute WNV infection as an explanatory etiology in cases of multifocal chorioretinitis, even without neurological involvement.

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Section: Discussionmentioning

confidence: 99%

Bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus infection: a case report

Valsecchi,

Veronese,

Roda

et al. 2024

BMC Ophthalmol

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“…[70]. WNV-associated chorioretinitis often presents with minimal symptoms, such as floaters, a mild vision reduction, redness, ocular pain, visual field defects, or diplopia [4,7,67,71,72].…”

Section: Ocular Manifestationsmentioning

confidence: 99%

“…Other manifestations have been described, including non-granulomatous anterior uveitis, retinal hemorrhages, focal or diffuse retinal vascular sheathing, vascular leakage, occlusive vasculitis, congenital chorioretinal scarring, zones of atrophy and mottling of the RPE, macular edema, optic neuritis, papilledema, and binocular diplopia related to sixth cranial nerve involvement [6,7,44,67,68,72,76,77]. Patients (n = 51 eyes) with intraocular inflammation tested positive for WNV-related vitritis (73%), papilledema (14%), intraretinal hemorrhages (43%), vasculitis (32%), and retinal occlusive vasculitis (16%) [71].…”

Section: Ocular Manifestationsmentioning

confidence: 99%

Ocular Manifestations of Flavivirus Infections

Zina,

Hoarau,

Labetoulle

et al. 2023

Pathogens

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Flaviviruses are a group of positive-sense, single-stranded RNA viruses predominantly transmitted by arthropods (mainly mosquitoes) that cause severe endemic infections and epidemics on a global scale. They represent a major cause of systemic morbidity and death and are expanding worldwide. Among this group, dengue fever, the West Nile virus, yellow fever, Japanese Encephalitis, and, recently, the Zika virus have been linked to a spectrum of ocular manifestations. These manifestations encompass subconjunctival hemorrhages and conjunctivitis, anterior and posterior uveitis (inclusive of vitritis, chorioretinitis, and retinal vasculitis), maculopathy, retinal hemorrhages, and optic neuritis. Clinical diagnosis of these infectious diseases is primarily based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular involvement. Diagnosis confirmation relies on laboratory testing, including RT-PCR and serological testing. Ocular involvement typically follows a self-limited course but can result in irreversible visual impairment. Effective treatments of flavivirus infections are currently unavailable. Prevention remains the mainstay for arthropod vector and zoonotic disease control. Effective vaccines are available only for the yellow fever virus, dengue virus, and Japanese Encephalitis virus. This review comprehensively summarizes the current knowledge regarding the ophthalmic manifestations of the foremost flavivirus-associated human diseases.

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“…Other inflammatory lesions, such as retinitis, macular edema, atrophic lesions of the retinal pigment epithelium, optic disc swelling, optic neuritis, neuroretinitis, and papilledema, have also been reported [ 14 , 17 , 18 , 19 , 20 , 28 ]. Other neuro-ophthalmic manifestations have been described, including retrogeniculate damage, ocular nerve palsy caused by cranial nerve involvement [ 14 , 29 , 30 ], and nystagmus secondary to encephalitis [ 31 , 32 ]. Alpert et al have reported ocular manifestations in the context of congenital infection, where the infant’s mother had developed paraplegia due to WNVI during the second trimester of her pregnancy [ 16 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Ocular Manifestations of West Nile Virus

et al. 2020

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Ocular manifestations are a feature of West Nile virus infection. They mostly occur in association with severe neuroinvasive disease. Linear chorioretinitis is suggestive of the diagnosis and may raise diagnostic suspicion when associated with evocative systemic signs, and in an epidemic context. Various other less specific inflammatory ocular manifestations have been reported, including anterior uveitis, occlusive retinal vasculitis, optic neuritis, and diplopia. The pathophysiology of ocular disease remains unclear, but it reflects the neuroinvasiveness of the disease. Although ocular involvement most often resolves without visual sequelae, some patients may have permanent loss of vision, adding to the need for the development of a specific treatment and/or vaccines.

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West Nile virus infection and diplopia: a case report and review of literature

Cited by 4 publications

References 26 publications

Bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus infection: a case report

Bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus infection: a case report

Ocular Manifestations of Flavivirus Infections

Ocular Manifestations of West Nile Virus

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