Central retinal vein occlusion concomitant with dengue fever

Abstract

BackgroundDengue virus infection is on the rise and there is increasing number of ocular complications that are being reported. Most common ocular complications are macular edema, macular hemorrhages, and foveolitis. There are case reports on branch retinal vessel occlusions. Most of the ocular complications are attributed to the bleeding tendency and transudative process in dengue viral infection. This is a case report of ischemic central retinal vein occlusion (CRVO) concomitant with dengue fever.Case presentationA 41 year old Malay female was admitted to medical ward and diagnosed to have “dengue fever with warning signs”. On the day of admission she noted sudden onset of right eye blurring of vision. She presented to our clinic 1 week later. Ocular examination revealed right eye visual acuity of <20/1000 and ischaemic CRVO with macular edema. She had no other risk factors to develop retinal vein occlusion. She progressively developed proliferative retinopathy and received multiple laser therapy. There was no anterior segment neovascularization. However, her vision improved to only 20/400 despite of resolution of macular edema and new vessels elsewhere.ConclusionDengue virus infection is known to cause thrombocytopenia which can result in hemorrhagic events. It can also cause procoagulant state which can result in thrombotic events secondary to immune reaction. Awareness among treating physicians of such ocular complication which can result in significant morbidity for patient is necessary.

Unilateral inferior altitudinal visual field defect related to COVID-19

“…The proposed mechanisms for such ocular manifestations in viral entities include direct viral involvement or a delayed immune response to the viral antigen. [ 4 5 ] Posterior segmental involvement is usually seen in 1–4 weeks following the onset of fever in viral infections. [ 5 6 ] Like in our case the time lag of 10 days between acute infection and retinal manifestation suggests immune-mediated pathogenesis, post-viral infection.…”

Dengue fever complicated with acute ST elevation myocardial infarction - a therapeutic conundrum: our experience from two cases

“…In a Brazilian case series, 5.4% of all thrombotic events were reported in patients without dengue shock syndrome or dengue hemorrhagic fever. 4 Deep vein thrombosis 4,18 , pulmonary thrombo-embolism 4 , mesenteric vein thrombosis 4 and central retinal vein occlusion 19 are among the reported thrombotic events in dengue fever.…”

Inflammatory branch retinal artery and vein occlusion with panuveitis secondary to dengue fever

“…[ 2 ] Vascular occlusions have been reported albeit less commonly. [ 3 4 5 ] Branched retinal vein occlusion has been described in dengue fever. [ 3 ] Velaitham and Vijayasingham[ 4 ] had described a case of vein occlusion 1 week after the onset of DF.…”

“…[ 3 4 5 ] Branched retinal vein occlusion has been described in dengue fever. [ 3 ] Velaitham and Vijayasingham[ 4 ] had described a case of vein occlusion 1 week after the onset of DF. Their patient had no other systemic vascular risk factors and had subsequently developed proliferative retinopathy and was treated with laser photocoagulation.…”