Ocular Manifestations of Emerging Infectious Diseases

Moncef Khairallah; Rim Kahloun

Disclosures

Curr Opin Ophthalmol. 2013;24(6):574-580. 

In This Article

Abstract and Introduction

Abstract

Purpose of review Emergent and resurgent infectious diseases are major causes of systemic morbidity and death that are expanding worldwide mainly because of climate changes and globalization. Among them, specific diseases have been recently associated with ocular involvement. This review presents the ocular manifestations of selected emerging infectious diseases relevant to the ophthalmologist.

Recent findings An array of ocular manifestations, involving mainly the posterior segment, have been recently described in association with specific arthropod vector-borne diseases including rickettsioses, West Nile virus, Rift Valley fever, Dengue fever, and Chikungunya. Influenza A (H1N1) virus has also been recently associated with ocular involvement. On the contrary, with advances in laboratory testing applied to ocular fluids, new infectious agents, mainly viruses, are increasingly being found to be associated with uveitis.

Summary Emerging infectious diseases should be considered in the differential diagnosis of retinitis, chorioretinitis, retinal vasculitis, optic neuropathy, or any other ocular inflammatory condition in a patient living in or traveling back from a specific endemic area. On the contrary, ocular fluid sampling and analysis for specific new pathogens can be recommended in selected patients with uveitis of unexplained cause.

Introduction

Arthropod vector-borne diseases are among the most important emergent and resurgent infections that are transmitted to humans by the bite of arthropods, mainly mosquitoes and ticks. Most of them are prevalent in warm regions, but they tend to spread into new geographic areas mainly because of climate changes and globalization. Systemic disease may range from mild febrile illness to severe, potentially lethal systemic involvement.

Specific arthropod vector-borne diseases have been recently associated with uveitis and other ocular manifestations including rickettsioses, West Nile virus (WNV) infection, Dengue fever, Rift Valley fever (RVF), and Chikungunya.[1] Doxycycline is the treatment of choice for rickettsial disease, and therapy for arboviral diseases is mostly supportive. Prevention, including public measures to reduce the number of vectors and personal protection, remains the mainstay for arthropod vector-borne disease control. An array of ocular manifestations has also been described in association with influenza A (H1N1) virus, human herpes virus six (HHV-6), parechovirus, and parvovirus.[1]

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