Bakar, Farah Abu
(2018)
Evaluation of ocular manifestations and its predictors in dengue patients in Hospital Selayang.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background:
Dengue is the most rapidly spreading mosquito-borne disease in the world causing a
substantial public health burden in the Western Pacific Region. It is a major cause of
mortality and morbidity in Malaysia. Malaysia is hyperendemic for dengue, as
evidenced by simultaneous presence of all four dengue serotypes (DENV-1, DENV-2,
DENV-3, DENV-4). However, the predominant serotype differs from year to year and
varies across the different states in Malaysia. Dengue fever has a wide spectrum of
clinical manifestations with varying degrees of severity. Different dengue serotypes may
contribute to the variability and severity of manifestations. Over the recent years, there
has been increasing numbers of cases of ocular manifestations in dengue, from mild selflimiting
presentation to sight threatening conditions.
Objectives:
The objectives of this study are to determine the prevalence of ocular manifestations in
dengue patients, to determine the association between ocular manifestations and the
different serotypes of dengue virus and to identify the predictors of ocular
manifestations in dengue.
Methods:
This is a cross-sectional study conducted in Hospital Selayang, Gombak, Malaysia. One
hundred and thirty eight patients diagnosed with dengue fever were recruited from
January 2017 to January 2018. Complete ocular examination was done for each patient
including assessment of macula thickness using Heidelberg Spectral-Domain Optical
Coherence Tomography (OCT). Serum blood sample is sent for full blood count and
dengue serotype. Reverse transcription- polymerase chain reaction (RT-PCR) method
was used to identify the dengue serotypes DENV-1, DENV-2, DENV-3 and DENV-4.
Findings were analysed using Statistical Package for Social Sciences (SPSS) comparing
ocular manifestations among the different dengue serotypes.
Results:
Ocular manifestations were present in 18 (13%) patients from the study. Fourteen (10%)
patients had eye redness. Subconjunctival haemorrhage was the commonest eye findings
seen in 14 patients in which 9 (64%) patients were infected by DENV-1 (p=0.019).
Fundus findings were present in 3 patients including 2 maculopathy. One patient had
anterior uveitis and is found to be associated with DENV-3 (p= 0.014)Age, gender,
ethnicity and full blood count values including platelet level were found not to be
significant predictors in this study (p>0.05).
Conclusion:
Ocular manifestations are prevalent amongst dengue patients. There is association
between specific dengue serotype with ocular manifestations. There is no significant
predictors of dengue ocular manifestation identified in this study. Further research and
larger studies need to be conducted to evaluate correlation between the different
serotypes with other types of ocular manifestation and its severity.
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