Dengue and chiasmal compression

Compressão de quiasma e dengue

Dear Editor,

The recent report on “dengue and chiasmal compression” is very interesting⁽¹⁾. Suzuki et al. reported a case “presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke’s cleft cyst apoplexy” and concluded that “apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual loss and dengue fever⁽¹⁾”. The hemorrhagic complications of severe dengue infection are not uncommon and may present with ophthalmological symptoms. In fact, tumor apoplexy may be a complication to dengue and can sometimes be observed in cases without any previous tumor history. Focusing on the specific reported case of Rathke’s cleft cyst apoplexy, Kim noted that “the occurrence of symptomatic pituitary hemorrhage into a Rathke’s cleft cyst (RCC) is extremely rare⁽²⁾”. Indeed, there are also other conditions relating to bilateral visual loss in dengue that should be included in differential diagnoses⁽³⁾, e.g., dengue maculopathy, which may result in subacute bilateral visual loss⁽⁴⁾; retinal hemorrhage, optic neuropathy, and angle closure glaucoma^(5-6).

• Funding: No specific financial support was available for this study.

REFERENCES

• ¹
  Suzuki AC, Araújo RB, Souza EC, Monteiro ML. Bilateral acute visual loss from Rathke’s cleft cyst apoplexy in a patient with dengue fever. Arq Bras Oftalmol. 2014;77(5):330-3.
• ²
  Kim E. A Rathke’s Cleft Cyst presenting with apoplexy. J Korean Neurosurg Soc. 2012;52(4):404-6.
• ³
  Schmitt ER, Kohnen T, von Jagow B. [Acute bilateral loss of visual acuity following dengue fever]. Klin Monbl Augenheilkd. 2013;230(11):1142-3. [in German].
• ⁴
  Braithwaite T, Nabarro L, Tufail A. Subacute bilateral vision loss resulting from dengue maculopathy. BMJ Case Rep. 2013;2013. pii: bcr2013200542.
• ⁵
  Kumar V, Kataria R, Mehta VS. Dengue hemorrhagic fever: a rare cause of pituitary tumor hemorrhage and reversible vision loss. Indian J Ophthalmol. 2011;59(4):311-2.
• ⁶
  Pierre Filho Pde T, Carvalho Filho JP, Pierre ET. Bilateral acute angle closure glaucoma in a patient with dengue fever: case report. Arq Bras Oftalmol. 2008;71(2):265-8.

Publication Dates

• Publication in this collection
  Mar-Apr 2015

History

• Received
  16 Dec 2014
• Accepted
  15 Jan 2015