Alterações oculares em pacientes diagnosticados com dengue em hospital de referência na cidade de Manaus, Amazonas

Abstract

Dengue is the most prevalent mosquito-borne viral disease in humans. It is endemic in tropical and subtropical regions and has become, in recent decades, a serious public health problem in the world. The disease causes numerous systemic and ocular complications, and among these, those related to the retina, can reduce visual acuity or even lead to vision loss. Dengue complications related to the visual apparatus are often neglected, however, they have become more valued due to the increasingly frequent incidence. This study aims to determine the prevalence of ocular alterations in patients diagnosed with dengue hospitalized at the Fundação de Medicina Tropical, Doutor Heitor Vieira Dourado (FMT-HVD), a reference center for infectious and parasitic diseases in Manaus, Amazonas, Brazil. This is an observational, analytical and prospective study, case series type, which studied 33 patients among those admitted to the FMT-HVD, with positive clinical pathology exams, during a period of 90 days, of a dengue epidemic in the year de 2011. The investigations included: visual acuity measurement, macular evaluation with Amsler screen, fundus biomicroscopy, retinography and optical coherence tomography (OCT). The mean age of the patients was 35.48 years (minimum age 17 years and maximum age 69 years). The main symptoms reported were blurred vision, followed by retroocular pain, photopsia, halos, foreign body, scotoma, double vision and floaters. Visual acuity ranged from 20/20 to 20/40 (median 20/30). The macular evaluation performed with an Amsler mesh was unsatisfactory for 3 patients. The most common retinal findings were perimacular edema, macular edema, retinal hemorrhage, vasculitis, retinal pigment epithelium (RPE) changes. Optical coherence tomography recorded retinal edema in 16 patients (51.51%). In all cases the disease was self-limiting and resolved spontaneously without treatment. Therefore, this study confirms that ocular manifestations in dengue are varied in the posterior segment and are frequent in hospitalized patients evaluated in this study.