Outbreak of Rift Valley Fever Retinitis in Rwanda: Novel Imaging Findings and Response to Treatment with Corticosteroids.
| Autor: | De Clerck I; Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.; Department of Ophthalmology, Military Hospital Queen Astrid, Brussels, Belgium.; Department of Ophthalmology, Rwanda Charity Eye Hospital, Kamonyi, Rwanda. |
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| Jazyk: | angličtina |
| Zdroj: | Ocular immunology and inflammation [Ocul Immunol Inflamm] 2024 Sep; Vol. 32 (7), pp. 1374-1379. Date of Electronic Publication: 2023 Aug 16. |
| DOI: | 10.1080/09273948.2023.2246549 |
| Abstrakt: | Purpose: To describe the clinical and epidemiological characteristics of the first epidemic of Rift Valley Fever retinitis in Rwanda and to report novel imaging findings and a possible role for corticosteroids. Methods: Retrospective analysis of all patients who presented with presumed Rift Valley Fever retinitis at the Rwanda Charity Eye Hospital over a period of 4 months in 2022. Multimodal images are reviewed including optical coherence tomography, fluorescein angiography, color, infrared, red-free, and autofluorescence photography. Results: The newly identified arciform hyporeflective pattern on infrared imaging was present in 100% of patients. Out of 9 patients treated with oral corticosteroids, 7 (78%) experienced a visual acuity increase of at least 0.2 during follow-up, in comparison to only 4 (28%) out of 14 of untreated patients. Out of four patients treated with a subtenon corticosteroid injection, only one (25%) reached this threshold. Post-hoc pairwise comparison with Bonferroni correction revealed a significant difference in average visual acuity improvement ( p = 0.034) between patients receiving oral corticosteroids (0.35 ± 0.07) versus no treatment (0.11 ± 0.04). Conclusion: The identified arciform hyporeflective pattern on infrared imaging appears to be characteristic of Rift Valley Fever retinitis and should be known to clinicians working in endemic regions. Compared to a historical cohort and to untreated patients in this non-randomized study, there appears to be a benefit of treatment with oral corticosteroids. |
| Databáze: | MEDLINE |
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