Bilateral eye Dengue maculopathy: A hidden threat to vision.

Abstract

Background: Dengue maculopathy is a rare but potentially cause sight-threatening ocular complication of dengue fever. This case report highlights      a case of a healthy 19 years old adult with bilateral eye dengue maculopathy.

Methodology: Case report

Result: We present a case of a 19-year-old boy with dengue fever presented with bilateral eye sudden, painless blurring of vision. On examination, visual acuity was 6/6 in both eyes. Anterior segment was unremarkable. Fundus examination revealed bilateral macula edema with mild hyperemia of the left optic disc superiorly. On examination, visual acuity was 6/6 in both eyes, with no relative afferent pupillary defect (RAPD) detected. Assessment of the right optic nerve showed a superior nasal visual field defect on confrontation testing, along with decreased light brightness and red saturation (about 70%) in the right eye. Colour vision remained normal in both eyes. Optical coherence tomography (OCT) of the macula  confirmed bilateral macula edema, more pronounced in the right eye. Vision drop two days after admission, right eye 6/24 and left eye 6/24 ph 6/18.  The patient was started on intravenous methylprednisolone 250mg four times daily for three days followed by oral prednisolone 60mg OD for 11 days after infection has been      ruled      out. At the one-month follow-up, her visual acuity both eye improved to 6/6 and OCT macula showed resolution of macula edema      in either eye.

Conclusion: This case emphasizes      the importance of early diagnosis with the help of OCT and visual field testing to assess the severity of dengue maculopathy. Prompt treatment with intravenous steroid can help prevent permanent visual loss.