Maculopathy and dengue.To the Editors: We thank Su and Chee (1) for their interest in our article, "Retinal 1. pertaining to the retina. 2. the aldehyde of retinol, derived from absorbed dietary carotenoids or esters of retinol and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. The two isomers 11-cis retinal and all-trans retinal are interconverted in the visual cycle. Hemorrhages capillary hemorrhage the oozing of blood from the minute vessels. cerebral hemorrhage hemorrhage into the cerebrum; see stroke syndrome. concealed hemorrhage internal h. in 4 Patients with Dengue dengue /den·gue/ (den´ge) an infectious, eruptive, febrile, viral disease of tropical areas, transmitted by Aedes mosquitoes, and marked by severe pains in the head, eyes, muscles, and joints, sore throat, catarrhal symptoms, and sometimes a skin eruption and painful swellings of parts. Fever" (2). We reported the findings of this small case series to highlight the presence of retinal hemorrhage as a manifestation of ophthalmic complication in patients with dengue fever Dengue hemorrhagic fever, a severe form of the disease, can cause hemorrhage, shock, and encephalitis. It occurs when a person who has acquired immunity to one of the viruses that cause dengue fever is infected by a different dengue virus. It is a leading cause of death among children in Southeast Asia and in recent years has become increasingly prevalent in tropical America. There is no specific treatment for dengue fever except good nursing care.. We wanted to describe characteristic clinical features (such as association of onset of visual symptoms with resolution of fever and nadir nadir (nā`dər) [Arab.,=opposite], in astronomy, the point on the celestial sphere directly opposite the zenith, i.e., directly beneath the observer. of thrombocytopenia immune thrombocytopenia that associated with the presence of anti-platelet antibodies (IgG). throm·bo·cy·to·pe·ni·a (thr  m b) and propose epidemiologic explanations for the sudden rise in the incidence of observed ocular complications of dengue fever in our population. Our article did not attempt to conclude that the retinal hemorrhages were responsible for the patients' visual symptoms, as suggested by Su et al. In fact, we stated that in all 4 patients "fundoscopic examination showed macular hemorrhages and exudative maculopathy bull's eye maculopathy increase of pigment of a circular area of the macula retinae accompanying degeneration, occurring in various toxic states and diseases. mac·u·lop·a·thy (m  k." The range of dengue-related ophthalmic complication is still being investigated, and we agree with Su and Chee that other ophthalmic manifestations may occur in patients with dengue fever. In a retrospective observational case series involving 22 eyes of 13 patients with visual impairment from dengue infection, carried out in our hospital, Chan et al. (3) found evidence of retinal hemorrhage, macular edema, cotton wool spots, retinal vasculitis systemic necrotizing vasculitis any of a group of disorders characterized by inflammation and necrosis of blood vessel walls. vas·cu·li·tis (v sky, exudative retinal detachment, and anterior uveitis heterochromic uveitis see under iridocyclitis. sympathetic uveitis see under ophthalmia. u·ve·i·tis (y  . Therefore, physicians and ophthalmologists should be aware of the possibilities of ophthalmic complications in the management of patients with dengue fever. References (1.) Su DH, Chee SP. Maculopathy in dengue fever. Emerg Infect Dis. 2006;12:707. (2.) Chlebicki MP, Ang B, Barkham T, Laude A. Retinal hemorrhages in 4 patients with dengue fever. Emerg Infect Dis. 2005; 11:770-2. (3.) Chan DP, Teoh SC, Tan CS, Nah GK, Rajagopalan R, Prabhakaragupta MK, et al. Ophthalmic complications of dengue. Emerg Infect Dis. 2006;12:285-9. Address for correspondence: Augustinus Laude, Tan Tock Seng Hospital, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore; email: laude_augustinus@ttsh.com.sg Augustinus Laude, * Maciej Piotr Chlebicki, * Brenda Ang, * and Timothy Barkham * * Tan "rock Seng Hospital, Singapore |
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