Dengue infection related ocular pathology whether as a direct manifestation of coagulopathy or as a sequale of immunological reaction is being increasingly recognized in endemic regions and has expanded out into a spectrum with pan ocular presentation. Authors present a case of a young female from an endemic region who developed visual field abnormality and loss of vision several days after onset of fever. She was diagnosed with dengue virus infection and subsequently went on to develop thrombocytopenia requiring transfusion. Detailed ophthalmological evaluation revealed maculae edema, and changes consistent with neuroretinitis and posterior segment vasculitis. She was treated with a combination of pulse steroid therapy and intravitreal dexamethasone injection. Patient went on to have excellent visual recovery on follow up with no persisting visual field deficit.
Arteriovenous malformations are abnormal tangled blood vessels with multiple irregular connections between arteries and veins. These malformations can occur anywhere with a preponderance to the spinal cord and brain. AV-malformations are usually congenital and patients might also have an associated intracranial aneurysm. Ophthalmic manifestations of AVM depend upon the location, varying from being asymptomatic to visual phenomena, field defects, diplopia, nystagmus etc. AV malformations in the cortical or occipital lobe produce visual symptoms which are transient. They can be associated with scotomas and migraine type headache. Signs and symptoms of brainstem AVMs are nonspecific and may include diplopia, nystagmus, dizziness, ocular motor nerve palsy, gaze palsy, anisocoria, or pupillary light-near dissociation. Findings are usually unilateral. There can be transient monocular vision loss due to the "steal phenomenon" in rare cases. Diagnosis of an AVM are based on angiographic findings which demonstrate an engorged arterial system, rapid filling of the malformation and outflow of the venous system.
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