Hypotension and anaemia--a blinding combination

Area of Science:

• Ophthalmology
• Infectious Diseases
• Nephrology

Background:

• Dengue hemorrhagic fever (DHF) is a severe mosquito-borne viral infection.
• Anemia and hypotension are known complications of DHF and medical interventions like dialysis.
• Optic neuropathy is a rare but serious complication of systemic illness.

Observation:

• A patient with severe DHF, anemia, and hypotension during dialysis developed sudden, complete blindness.
• Clinical examination and radiological findings suggested an ischemic optic neuropathy.
• The case highlights a potential link between DHF complications and vision loss.

Findings:

• The patient's vision loss was attributed to posterior ischemic optic neuropathy.
• Hypotension during dialysis in the context of severe DHF and anemia was the likely precipitating factor.
• Differential diagnoses for optic neuropathy in this clinical setting were considered.

Implications:

• This case underscores the importance of monitoring visual function in patients with severe DHF, especially those undergoing dialysis.
• Awareness of ischemic optic neuropathy as a complication is crucial for timely diagnosis and management.
• Further research may be needed to elucidate the precise mechanisms linking DHF, hypotension, and optic nerve damage.