One Year Cross Sectional Study Of Ocular Manifestations In Dengue Fever Patients Admitted In Tertiary Care Hospital Belgaum

Abstract

Background and Objectives Dengue fever has emerged as one of the most important arthropod tropical infections in the recent years with an estimated 2.5 billion people at risk all over the world. Ocular manifestations in dengue fever are less studied. The objective of present study was to estimate the prevalence of ocular manifestations in a group of patients with dengue fever. Methods The present cross sectional study was conducted in Department of ophthalmology at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during October 2011 to September 2012 on 100 patients with dengue fever proved by micro ELISA test. Detailed ocular examination in all patients was carried out, including visual acuity, anterior segment examination with torch light while examining bed side, Slit lamp bio microscopy in ambulatory patients examined in OPD, and fundus examination with direct and/or indirect ophthalmoscope. Ppercentage of the total patients having ocular manifestation of DF was calculated and P value is calculated to study association of platelet count with the ocular complications. Result One hundred patients hospitalized with a diagnosis of dengue fever or DHF were included in the study. The patients ranged in age from 6 to 59 years with a mean of 22.32 years. All patients presented with a history of fever ranging from v 37.8 0 C to 40.3 0 C. Fever was present in all 100 ( 100% ) patients. Other common presenting symptoms were chills ( 84% ) , headache ( 52% ) , vomiting ( 50% ) , nausea ( 20% ) , giddiness ( 7% ) , backache ( 40% ) , myalgia ( 49% ) . The 60 % of the patients were not having any ocular manifestation. Only 40 % patient had ocular symptoms and sign. Ocular bleeding manifestations were present in 40 ( 40% ) patients. Subconjunctival haemorrhage was the commonest haemorrhagic manifestation & was found in 37 ( 37% ) patients, followed by superficial retinal haemorrhage in 2 ( 2% ) patients and macular haemorrhage in 1( 1% ) patient. Marked thrombocytopenia ( platelet count less than 50,000/µL ) was present in 87.5 % of patients.35 out of 73 patients who had thrombocytopenia had ocular haemorrhage, and the association was statistically significant ( p<0.026) . Conclusion The study concluded that dengue is a significant cause of ocular disease with 40( 40% ) patients having ocular manifestations. The commonest ocular lesions observed were the anterior segment manifestations such as, subconjunctival petechial haehmorrhage and diffuse haemorrhage. The less common ocular manifestations seen were the posterior segment manifestations such as superficial retinal haemorrhage and macular haemorrhage. The prevalence of ocular manifestations correlated significantly with Dengue WHO clinical stage 2. We found close correlation with ocular manifestations of dengue and thrombocytopenia ( platelet count <50,000cells/µl ) which was statistically significant. The study conducted by our microbiology department on dengue patients, showed that majority have serotype 1 and 3 as causative virus by PCR method. But to confirm this finding another larger sample size study required