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Year : 2022  |  Volume : 4  |  Issue : 1  |  Page : 5

Dengue associated retinal hemorrhages and macular edema

Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India

Date of Submission18-Nov-2021
Date of Acceptance01-Dec-2021
Date of Web Publication09-Feb-2022

Correspondence Address:
Dr. Srinivasan Sanjay
Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pajo.pajo_122_21

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How to cite this article:
Sanjay S, Kawali A, Mahendradas P. Dengue associated retinal hemorrhages and macular edema. Pan Am J Ophthalmol 2022;4:5

How to cite this URL:
Sanjay S, Kawali A, Mahendradas P. Dengue associated retinal hemorrhages and macular edema. Pan Am J Ophthalmol [serial online] 2022 [cited 2023 Sep 29];4:5. Available from: https://www.thepajo.org/text.asp?2022/4/1/5/337475

Dear Editor,

We read with interest the article by Joshi and Wadekar[1] It was noted that the patient received platelet transfusion when her platelet count dropped to 10,000/μl on the 3rd day of admission. Platelet transfusion is associated with the risk of permanent visual impairment as we have published in our series of patients.[2] Prophylactic platelet transfusion has no added advantage over supportive care. The lack of efficacy of prophylactic platelet transfusion, combined with a higher risk of adverse events, leads us to discourage the practice of routine prophylactic platelet transfusion in adult dengue.[2] Was the patient transfused with single donor platelets or pooled donor platelet? Hyper-reflective inner layers on optical coherence tomography (OCT) may indicate a retinitis along with cystoid changes which are common in post fever uveo retinal sequelae.[3]

Dengue can be associated with vitreous and preretinal hemorrhage so the authors claim that this is the first report of cerebral hemorrhage with retinal hemorrhage and macular edema seems far-fetched.[3],[4]

We have reported earlier that macular edema secondary to epidemic retinitis which may resolve without steroids[5] Majority of cases of post fever uveo-retinal sequelae are self-limiting and treatment may be warranted only in severe sight-threatening cases.

Post-treatment fundus and OCT images may add value to the authors' report.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Joshi RS, Wadekar PD. Bilateral retinal hemorrhages and macular edema in a patient with dengue fever associated with cerebral hemorrhage. Pan Am J Ophthalmol 2021;3:34.  Back to cited text no. 1
  [Full text]  
Sanjay S, Agrawal S, Jain P, Mahendradas P, Kawali A, Shetty N. Permanent visual impairment in dengue fever following platelet transfusion: A series of 5 cases. Ann Acad Med Singap 2021;50:588-92.  Back to cited text no. 2
Sanjay S, Agrawal S, Mahendradas P, Kawali A, Gupta A, Shetty R. Post fever uveoretinal manifestations in immunocompetent individual. EMJ Allergy Immunol 2020;5:91-105.  Back to cited text no. 3
Sanjay S, Au Eong KG. Bilateral vitreous haemorrhage associated with dengue fever. Eye (Lond) 2007;21:144-5.  Back to cited text no. 4
Kawali A, Srinivasan S, Mohan A, Bavaharan B, Mahendradas P, Shetty B. Epidemic Retinitis with Macular Edema -Treatment Outcome with and without Steroids. Ocul Immunol Inflamm. 2021;29:932-936. doi: 10.1080/09273948.2019.1704792. Epub 2020 Jan 21.  Back to cited text no. 5

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