Dados do Trabalho

Título

DENGUE FEVER-RELATED OPTIC NEURITIS

Objetivo

Although dengue fever may result in a wide spectrum of neurological and ophthalmological complications, few cases of optic neuritis (ON) have been described to occur in association with the infection. Herein we report a series of six patients who develop optic neuritis during the acute or convalescent phases of the disease.

Relato do caso

Patients were seen at the Division of Neuro-Ophthalmology of the Federal University of Minas Gerais Medical School, and had the diagnosis of dengue fever confirmed clinically or by positive serology.
Six patients with established diagnosis of dengue virus infection developed ON. In 3 patients loss of vision was observed in the first week, and in 3 patients during the second or fourth week following the opening manifestations of the infection. One patient reported visual loss three days following H1N1 vaccination which was given 10 days after dengue fever remission. There were 4 females and 2 males with age ranging from 14 to 68 years. Dengue infection was confirmed by serology in 5 patients. Optic neuritis was bilateral in 5 patients. Visual acuity at onset was NPL in 4 eyes, CF in 2, 20/800 in 2, 20/200 in 2, and 20/40 in one eye. Papillitis was observed 4 eyes. Final VA was worse or equal to 20/400 in 6 eyes (NPL in 2), and better or equal to 20/40 in 5 eyes. Nine eyes developed optic atrophy in the follow-up. Brain MRI showed hyperintense signal in the optic nerve in 4 eyes and unspecific small patches in the cerebral white matter in 3 patients. CSF analysis was performed in 5 patients and showed no abnormality. All patients were given pulses of IV methylprednisolone which resulted in partial recovery in 2 and complete recovery in one patient.

Discussão

Optic neuritis may occur as a rare complication of dengue fever during its acute and convalescent phases. Dengue fever-related ON is usually bilateral and may result in permanent and severe visual loss