Optic neuritis as the ocular manifestation of dengue infection: a case report

Abstract

Optic neuritis is characterized by decreased vision, impaired colour perception, relative afferent pupillary defects, and scotoma. Optic neuritis following dengue infection is rare and might be underdiagnosed. The pathophysiology of optic neuritis after dengue infection is still unclear and there are only a few reports. We report a case of bilateral simultaneous optic neuritis in a young female adult following dengue haemorrhagic fever. On presentation, she complained of blurred vision, pain around the eyes, central scotoma, and progressively worsening visual acuity to no perception of light in both eyes. The next day, laboratory examination showed leucopoenia (6.74 [4.5–11.5 103/μL]) and lymphocytosis (52.7 [18–42%]), suggesting viral infection with positive anti-dengue IgM and IgG. The patient received intravenous pulse steroid therapy according to the Optic Neuritis Treatment Trial. At 3 months follow-up, best corrected visual acuity improved to 6/6, with pale optic discs but normal perimetry. Although complications of dengue fever in the eye are rare, early recognition must be established to prevent permanent vision loss.