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Table of Contents
LETTER TO EDITOR
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
India
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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 2022 Oct 7];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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
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]  
2.
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
    
3.
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
    
4.
Sanjay S, Au Eong KG. Bilateral vitreous haemorrhage associated with dengue fever. Eye (Lond) 2007;21:144-5.  Back to cited text no. 4
    
5.
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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