Maculopathy and vasculitis associated with dengue in a young patient

Abstract

The dengue virus is an arbovirus of the Flaviviridae family. The Aedes aegypti mosquito is its main vector. The clinical presentation of dengue varies from a febrile illness to life-threatening dengue shock syndrome. The main symptom of dengue is fever that lasts 3 to 7 days. Traditionally, it has been thought that ocular pathology in dengue is rare, although its involvement is increasingly recognized. The objective of this article is to report the case of a patient who presented bilateral dengue maculopathy associated with vasculitis. A 32-year-old male patient with decreased vision of 48 hours of evolution. The only history was that he had been diagnosed with dengue fever 5 days before. The fundus examination revealed perivascular inflammation and discoloration changes in the macular area of both eyes. On OCT, inflammatory infiltrates were observed in the middle layers of the retina of both eyes. After one month, the patient recovered his total visual acuity and the retinal signs completely resolved under treatment with oral meprednisone every 12 hours and topical treatment with prednisolone every 8 hours. Currently there is no established treatment for dengue maculopathy. Active monitoring of the patient is required. Most lesions resolve spontaneously. But topical and systemic corticosteroids and immunomodulators can also be considered for treatment.