Fascinating case study on tropical blindness

Case study opens Mystery Cases session at first Young Retinal Specialists Day

Leigh Spielberg

Posted: Tuesday, September 12, 2017

Sarah Thiele

The Mystery Cases session, part of the first Young Retinal Specialists (YOURS) Day, was opened by Dr Sarah Thiele, University Eye Hospital, Bonn, Germany. Dr Thiele presented her mystery case, entitled “Tropical Blindness”, to a full house early on Friday morning at the 17th Annual EURETINA conference.

Her patient was an 18-year-old female who had volunteered to spend a year in the Philippines doing charity work. But her stay was cut short when she suffered sudden onset of high fever and skin flush, followed by equally sudden loss of central vision in both eyes, all within a week after arrival.

Fundus photography showed a slightly darker red macular appearance, more pronounced in OS (BCVA: 20/200) than OD (BCVA: 20/50). There were no white lesions, large lesions were apparent on infrared, autofluorescent and multicolour photography. OCT displayed disruption of the outer retinal layers, but fluorescein angiography showed neither leakage nor vasculitis.

Diagnosis? A clever fellow in the audience suggested acute macular neuroretinopathy (AMN) associated with Dengue viral infection, which turned out to be the correct answer. AMN, first described in 1975, typically occurs in Caucasian women, is associated with viral infections and leads to a slow, often partial recovery of visual function.

YOURS, a new initiative for young retinal specialists, was designed to provide a platform to ensure that issues and focus points of this specialist demographic are heard and addressed. This year’s YOURS Day was the first of what promises to be many.