ABSTRACT
Objective: To describe the clinical spectrum of ophthalmic manifestations in patients presenting with dengue fever during the outbreak at Lahore in autumn of 2011
Study Design: Prospective study
Place and Duration of Study: Combined Military Hospital Lahore, from Sep 2011 to Dec 2011
Material and Methods: This prospective study was conducted at CMH Lahore. Al most 3005 clinical dengue cases were recruited for the study from 39930 cases that reported at OPD with suspected dengue fever. All these patients were screened for ophthalmic involvement. These patients were subjected to serological analysis for detecting dengue specific IgM antibodies [IgM enzyme-linked immunoassay] and blood test for thrombocytopenia after taking written informed consent. The patients with ophthalmic involvement were subjected to detailed history, ocular examination including anterior and dilated posterior segment examination. Ophthalmic manifestations in these patients were recorded and tabulated according to the frequency
Results: The study showed that dengue fever could result in a variety of ocular complications. Majority of these complications were innocuous and self limiting. Most common is subconjunctival haemorrhage. Other includes retrobulbar haemorrhage, proptosis, increased IOP, vitreous haemorrhage, retinal haemorrhage and peri ocular ecchymosis. Vision threatening complications were seen in only 1 Percent of cases
Conclusion: Dengue fever can result in a range of ocular complications so ophthalmic examination should be performed in patients presenting with all forms of the disease. The most common is sub-conjuntival haemorrhage. The vision threatening complications among these occur with involvement of posterior segment including vitreous and retinal haemorrhages. This justifies detailed fund us examination of these patients with a dilated pupil
ABSTRACT
Hepatitis B virus [HBV] typically causes chronic hepatitis, cirrhosis, and hepatocellular carcinoma. It is associated with a variety of extrahepatic complications. We herein, present a rare extrahepatic complication of HBV infection. A 32-year man presented with melena, bleeding from gums and fever. Peripheral blood examination revealed anemia, macrocytosis and severe thrombocytopenia. His hepatitis B surface antigen [HBsAg] was positive but deoxyribonucleic acid [HBV DNA] by polymerase chain reaction [PCR] was negative. Other hepatitis, human immune deficiency virus [HIV], dengue, and autoimmune serology were negative. Bone marrow examination revealed megaloblastic erythropoiesis. There was mild to moderate reduction of megakaryocytes in bone marrow, which was not compatible with severe peripheral thrombocytopenia. His response to cyanocobalamin and folic acid was remarkable for myeloid cell lines and moderate for erythroid cell lines, but poor to platelet counts. Platelet counts gradually improved to safe limits with eltrombopag, likely reflecting autoimmune pathogenesis for thrombocytopenia. This case report highlights multiple targets of HBV infection with associated multiple pathogenetic mechanisms
ABSTRACT
Valsalva retinopathy is a rare condition characterized by preretinal haemorrhage in patients with H/O increased intrathoracic pressure caused by forceful exhalation against a closed glottis. We are presenting a case of a young male adult who developed bilateral valsalva retinopathy following strenuous exercise
Examination of his fundus revealed a round, circumscribed bright-red mound of blood over both maculae
The extent of the lesion in left eye was lesser than the right eye. He was managed conservatively and showed remarkable visual recovery with return of vision to normal in both eyes after 12 weeks