Emerging infectious uveitis: Chikungunya, dengue, Zika and Ebola: A review

Abstract

Recently recognized forms of uveitis include intraocular inflammations that occur during or following one of several emerging infectious diseases: chikungunya fever, dengue, Zika virus disease and Ebola virus disease. Anterior, intermediate, posterior and pan‐uveitis have been described in individuals infected with chikungunya virus. Persons who contract dengue or Zika viruses also may develop different types of uveitis in the course of the infection: maculopathy is a common manifestation of dengue eye disease, and Zika eye disease may cause hypertensive anterior uveitis or mimic a white dot syndrome. Up to one‐third of Ebola survivors develop aggressive uveitis, which is frequently associated with vision loss and complicated by cataract. There are no specific anti‐viral drugs for these forms of uveitis, and thus treatment is largely supportive. In this article, we summarize the systemic infectious diseases and virology, and describe the clinical presentations, outcomes and management of emerging viral forms of uveitis.

Seeking clarity on retinal findings in patients with COVID-19

“…Retinal changes have been reported for other emerging viral disorders, including chikungunya, dengue fever, Zika, Ebola virus disease, and yellow fever, among others. 3 Some of these retinal changes might even serve as non-invasive biomarkers of systemic disease, similar to what has been shown for yellow fever. 4 …”

“…Careful interpretation of novel imaging observations is essential in this context. In addition to microangiopathic changes (indicated by retinal cotton wool spots and microhaemorrhages), which are also seen in other viral conditions, 3 , 4 Marinho and colleagues 1 report hyper-reflective lesions on optical coherence tomography at the level of the retinal ganglion cell and inner plexiform layers. After carefully analysing these images, we argue that these changes represent oblique sections and cross-sections of perifoveal retinal blood vessels.…”

Causes of Hypertensive Anterior Uveitis in Thailand

“…Rubella virus (RV) was demonstrated in Europe and other countries and emerging viral agents as chikungunya, Zika, and Ebola viruses were also implicated. 5 Viral AU manifests predominantly as unilateral HAU often associated with some form of iris atrophy. 6 We performed a retrospective study of 31 consecutive HLA B27-negative patients with HAU in Thailand and examined the clinical manifestations of patients positive for PCR outcomes and compared their features to patients with negative results.…”

SARS‐CoV‐2 and COVID‐19 for the ophthalmologist

“…On the other hand, despite anecdotal reports of the detection of SARS‐CoV‐2 in intraocular tissue, whether the virus can directly induce intraocular inflammation remains an important issue to be determined 107 . Retinal changes in individuals with COVID‐19, including cotton wool spots, microhaemorrhages and even occlusion of larger retinal vessels and of the choriocapillaris are likely the consequence of microvascular damage and increased thrombogenesis, in the context of a systemic hyperinflammatory response, as also observed in other bodily organs, and in other viral infections, including dengue, chikungunya and even yellow fever 112,130,131 . Further prospective and controlled studies on the ocular manifestations of COVID‐19, possibly examining ocular samples and performing multimodal ophthalmic imaging, may shed light on many of the yet unanswered questions surrounding the impact of COVID‐19 on the eye.…”