CASE REPORT

Dengue hemorrhagic fever with severe ocular complication: case series

Anak Agung Mas Putrawati Triningrat , I Ketut Agus Somia, I Made Dwi Lingga Utama, NI Putu Ngurah Sri Yuliastini, Made Paramita Wijayati, Ariesanti Tri Handayani

Anak Agung Mas Putrawati Triningrat
Departement of Ophthalmology, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali. Email: masputra07@gmail.com

I Ketut Agus Somia
Internal Medicine Department, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali

I Made Dwi Lingga Utama
Pediatric Department, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali

NI Putu Ngurah Sri Yuliastini
Departement of Ophthalmology, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali

Made Paramita Wijayati
Departement of Ophthalmology, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali

Ariesanti Tri Handayani
Departement of Ophthalmology, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali
Online First: December 01, 2020 | Cite this Article
Triningrat, A., Agus Somia, I., Dwi Lingga Utama, I., Sri Yuliastini, N., Wijayati, M., Handayani, A. 2020. Dengue hemorrhagic fever with severe ocular complication: case series. Bali Medical Journal 9(3): 907-911. DOI:10.15562/bmj.v9i3.1946


Introduction: Ocular complication associated with Dengue Haemorrhagic Fever (DHF) is a rare condition with varied manifestations, ranging from subconjunctival hemorrhage to optic neuropathy. This condition's pathophysiological mechanism is not well understood, with several unpredictable conditions resulting in permanent visual loss. In this case series, three patients with severe ocular complications associated with DHF are presented.

Case Report: Case 1: a 16 years old girl presented with proptosis after diagnosed with DHF with no light perception. All findings were consistent with pan-ophthalmitis and retrobulbar hemorrhage. Unfortunately, the right eye turned into phthisis and spontaneous prolapse even with canthotomy with lateral cantholysis and steroid administration. Case 2: 10 years old boy presented with bilateral visual blurring within a month after being diagnosed with DHF with hand movement perception on both eyes and optic disc swelling. The visual acuity recovered to 20/20 in a month of steroid therapy with no optic disc swelling. Case 3: 52 years old man presented with proptosis and dengue shock syndrome with counting finger perception, swelled optic disc, and limited eye movement to all directions. The patient was diagnosed with optic neuritis and retrobulbar hemorrhage. Canthotomy with lateral cantholysis lateral and steroid therapy were planned, but the patient died before treatment was done.

Conclusions: Severe ocular complications should be anticipated and monitored in DHF patients. Although visual recovery is possible, permanent ocular complications can be severe and cause permanent visual loss.

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