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  • Title: Acute Macular Neuroretinopathy in Dengue Fever: Short-term Prospectively Followed Up Case Series.
    Author: Li M, Zhang X, Ji Y, Ye B, Wen F.
    Journal: JAMA Ophthalmol; 2015 Nov; 133(11):1329-33. PubMed ID: 26269969.
    Abstract:
    IMPORTANCE: The incidence of dengue fever (DF) increases every year. Macular complications of patients with DF may be more common than many ophthalmologists realize. During a DF outbreak in South China in 2014, we observed acute macular neuroretinopathy associated with DF. OBSERVATIONS: Among 9 patients (17 eyes) with maculopathy post-DF, 5 patients (55.6%) (9 eyes) manifesting acute macular neuroretinopathy were recruited from August 1, 2014, to September 30, 2014, with a 6-month ophthalmic follow-up. Infrared reflectance imaging demonstrated localized areas of hyporeflection in the macula. Spectral-domain (SD) optical coherence tomography (OCT) scanning through these areas revealed hyperreflection in the photoreceptor layer and disruption of its normal reflective structures. Subsequent SD-OCT demonstrated that the hyperreflection of the photoreceptor layer regressed gradually, followed by thinning of the outer nuclear layer. The external limiting membrane and ellipsoid zone became continuous; however, the interdigitation zone was not restored. The scotomas persisted in all 5 patients (9 eyes) by the last visit. All 5 patients (9 eyes) in this case series were complicated with classic dengue maculopathy signs, such as intraretinal hemorrhage and exudation, which were completely resolved during the follow-up. CONCLUSIONS AND RELEVANCE: These data suggest that acute macular neuroretinopathy is a major manifestation of dengue maculopathy, with persistent scotomas through at least 6 months.
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