Ocular complications of dengue are rare but are being increasingly recognized and reported, and can cause permanent blindness. Only a few cases of dengue maculopathy have been reported in travelers.

Heinemann et al. report a case of severe acute vision loss due to dengue maculopathy in a 29-year old German woman after a 20-day vacation in Vietnam and Cambodia.

Four days after returning home, the patient presented at an outpatient tropical medicine clinic with fever, chills, headache, sweating and myalgia (onset two days earlier), diarrhea (for prior seven days) and vomiting, which had resolved.

A positive nonstructural protein 1 antigen test and positive polymerase chain reaction test confirmed a dengue diagnosis. Dengue IgM and IgG were initially negative, but were detected by immunofluorescence one month later. After six days of fever, the patient presented to the emergency department with blurred vision and parasthesia on hands and feet, coinciding with the nadir of her platelet count (88 x 109/L).

Optical coherence tomography revealed detachment of, and a central shift in the retinal pigment epithelium, plus intraretinal cysts. However, after hospitalization and a short course of intravenous steroid (prednisolone) therapy, the patient’s vison fully recovered by nine months post-onset.

In conclusion, it is important to be aware of, and adequately manage the ocular manifestations of dengue in infected individuals and travelers to endemic regions in Asia.

https://www.ajtmh.org/view/journals/tpmd/103/5/article-p2026.xml

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