Sundar M D, Chawla R, Balaji A, Garg I, Kalathil R, Hasan N, Vikas SJ, Kumar A. Clinical features, optical coherence tomography findings and treatment outcomes of post-fever retinitis.
Ther Adv Ophthalmol 2021;
12:2515841420979111. [PMID:
33415316 PMCID:
PMC7750750 DOI:
10.1177/2515841420979111]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives:
To study the clinical features, optical coherence tomography (OCT) findings,
treatment options and follow-up outcomes of post-fever retinitis (PFR).
Subjects:
A total of 19 eyes of 13 patients, diagnosed with PFR (retinitis following
febrile episode) over 2 years were retrospectively studied.
Methods:
Documented history, baseline clinical features and systemic investigations
performed for PFR were reviewed. Fundus findings, foveal architecture on
swept-source OCT, the treatment options and the follow-up outcomes including
best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were
reviewed and analyzed.
Results:
Common fundus findings included whitish retinitis lesions (100%), macular
star (95%, 18eyes), retinal flame-shaped hemorrhages (63%, 12 eyes),
inflammatory retinal vessels (30%, 6 eyes), vitreous hemorrhage (one eye)
and OCT findings included neuro-sensory detachment (79%, 15 eyes),
intraretinal white dots (89.5%,17 eyes). The baseline median log MAR BCVA
and CFT were 1.30 (interquartile range (IQR):0.8–1.8) and 423 microns
(IQR:182–555). Overall, nine patients (12 eyes) received a combination of
oral doxycycline and oral steroids and four patients (7 eyes) received a
combination of oral doxycycline, oral steroid and intravitreal anti-vascular
endothelial growth factor (IVA). Significant improvement was evident at 8
weeks in median BCVA (0.50, IQR: 0.3–0.8, p < 0.05) and
median CFT (223 micron, IQR: 170–256, p < 0.05) though
only 26% (5 eyes) attained BCVA > = 6/12.
Conclusion:
Our study puts forth certain characteristic fundus and OCT features of PFR. A
combination of oral doxycycline and oral steroids as a treatment option
showed improvement in BCVA and CFT. Additional IVA helps in faster visual
recovery in patients presenting with severe macular edema at onset.
Collapse