Dengue maculopathy: visual electrophysiology and optical coherence tomography

The objective of this study was to evaluate the visual loss due to dengue fever using retinal and cortical electrophysiology and retinal imaging. The participants were three female patients with low visual acuity after dengue fever. They were evaluated by routine ophthalmological investigations, transient pattern electroretinogram (tPERG), transient pattern visual evoked cortical potential (tPVECP), and retinal optical coherence tomography (retinal OCT). tPERG and tPVECP amplitude (μV) and implicit time (ms) were the parameters evaluated using OCT retinal thickness (μm) and reflectivity. All patients presented low visual acuity and scotomata with or without changes in the oculus fundus. tPERG from two patients showed decreased amplitude or absence of the main components; it was not possible to record a reliable response in the third patient due to excessive blinking. tPVECP at 0.5 cpd was normal in all three patients, while at 2 cpd the main components were absent in one patient and normal in the other two patients. OCT image was abnormal in two patients, one of them with high reflectance areas and another with decreased retinal thickness (the third patient was not studied with this technique).The dengue fever can lead to visual impairment detectable by ophthalmological exams such as angiography, retinography, and OCT imaging, as well as retinal and cortical electrophysiology. Dengue maculopathy which could be caused by vascular alterations and/or aberrant immune response after infection may result in temporary or permanent visual losses.