PDF(Pubmed)
Abstract：
Although rare, dengue fever-associated ocular manifestations are a valid cause of visual impairment. Clinicians usually have a dilemma between vitrectomy and medical management if there is an associated vitreous hemorrhage. Vitrectomy has been rarely reported previously in the management of vitreous hemorrhage secondary to dengue fever. We report a case of a young adult who presented with bilateral vitreous hemorrhages. The diagnosis of dengue was confirmed by serology and a typical epidemiological context. The patient presented already having undergone yttrium aluminum garnet (YAG) laser hyaloidotomy for preretinal hemorrhage in the other eye, with a subsequent vitreous spread of the hemorrhage. Vitrectomy with internal limiting membrane (ILM) peeling was performed for the affected eye and the visual acuity was fully regained after a few weeks. Dengue fever can present with dense or sub-ILM hemorrhages. In our case, the vision quickly recovered after vitrectomy and ILM peeling. We, therefore, recommend early vitrectomy in cases with vitreous hemorrhage associated with sub-ILM involvement so as not to delay visual recovery.
摘要：
虽然罕见，登革热相关的眼部表现是视觉障碍的有效原因。如果存在相关的玻璃体出血，临床医生通常会在玻璃体切除术和医疗管理之间陷入困境。以前很少报道玻璃体切除术在登革热继发的玻璃体出血的治疗中。我们报告了一例年轻的成年人出现双侧玻璃体出血。血清学和典型的流行病学背景证实了登革热的诊断。该患者已经接受了钇铝石榴石（YAG）激光玻璃样切开术治疗另一只眼睛的视网膜前出血，随后玻璃体扩散出血。对受影响的眼睛进行带内界膜（ILM）剥离的玻璃体切除术，几周后视力完全恢复。登革热可表现为密集或亚ILM出血。在我们的案例中,玻璃体切除术和ILM剥离后视力迅速恢复。我们,因此,建议对伴有亚ILM受累的玻璃体出血患者进行早期玻璃体切除术，以免延迟视力恢复。
