Dengue Fever presenting with macular hemorrhages

To report ocular manifestations in cases of previously undiagnosed dengue fever.

A retrospective study was done to evaluate the cause of sudden painless loss of vision in three cases with history of fever. Detailed systemic evaluation and ophthalmologic examination consisting of fundus photographs, fundus fluorescein angiography, and optical coherence tomography were done, where needed.

All three patients tested positive for dengue serology, which had been undiagnosed earlier. Retinal hemorrhages were found in all three patients, while one patient also showed evidence of retinitis-like lesions. He was treated with oral steroids and showed improvement in visual acuity over a period of 6 weeks. Two of the three patients had subhyaloid hemorrhages, which were seen to resolve spontaneously.

A significant subset of patients with mild form of dengue fever may go undiagnosed.