Case series of ocular involvement due to dengue. First reported cases in Guatemala

Describe the ocular findings of a case series of 8 patients with a diagnosis of dengue.

Review of clinical records and interviews with patients during outpatient visits, after informed consent was obtained and following the ethical standards of the Helsinki declaration. The patients were diagnosed with diagnosis by IgM / IgG dengue serology in whom ocular involvement was identified, between January and October 2017 in Retinal-vascular clinic of the "Dr. Rodolfo Robles Valverde Hospital", Guatemala.

The 8 patients, 5 men and 3 women from rural areas in Guatemala, were diagnosed with dengue by IgM / IgG serology with associated ocular involvement. The mean age was 32.3 years, with the oldest being 45 years old and the youngest being 20 years old. The ocular manifestations identified were, 4 neuroretinitis, 3 venous obstructions, 3 maculopathies, 2 serous detachments, 1 episcleritis, and 1 vasculitis. Two patients developed optic atrophy after resolving the neuroretinitis, and 1 developed peri-foveal scarring after the maculopathy. The ocular involvement was resolved in all patients after treatment, with an improvement in visual acuity, although in some cases damage to the visual field developed as a sequela of neuroretinitis.

It is necessary to consider dengue as an important differential diagnosis in an endemic country such as Guatemala. There are a large number of ocular manifestations due to direct involvement, as well as by an immune system reaction, and thus avoid considering the different ocular manifestations as idiopathic, or due to a different condition.