Ocular manifestations of Dengue-fever

Dengue-Fever is a mosquito transmitted viral disease. It is endemic mainly in South-East Asia and Afrika. The clinical manifestation is divided into different stages. Ocular manifestations in travellers have been rarely reported. Patients: We present the cases of two patients, having just returned from a trip to Thailand. During their trip they had fallen ill with symptoms of classic dengue-fever. Findings: On examination visual acuity had decreased in both patients. In one patient we detected a relative central scotoma in perimetry and reduced amplitudes in VEP. In indirect ophthalmoscopy we found intraretinal haemorrhages, foveal lesions in the pigment epithelium, cotton-wool spots and a maculopathy. The fluorescein angiographic findings included extravasation in the macular region and block fluorescence. The diagnosis was confirmed by a rise in Dengue-fever antibody titre and the detection of flavivirus IgM antibodies. Conclusion: Dengue-fever and its ocular manifestation in Europeans is a rare condition. Expanding tourism to tropical countries may lead to an increasing number of cases.