Dear editor,
The article reports the main ophthalmic manifestations of a severed global public health issue; it is relevant for different diagnoses of ocular pathologies.(11 Esporcatte LP, Portes AJ. Manifestações oculares na febre Chikungunya. Rev Bras Oftalmol . 2019;78(5):338-41.) However, it is essential adding another possible ophthalmic manifestation of this disease, namely: strabismus caused by paralysis of the third ocular nerve. This is a rare condition, and uses to be an exclusion diagnostic. The beginning of the symptoms is observed after the acute phase of the disease caused by the neurotrophic virus. Infection releases cytokines that have neurotoxic action and can lead to apoptosis of neurons. It is not yet clear whether the virus can also cause greater intracranial pressure, which could lead to the paralysis of the cranial nerve.(22 Benzekri R, Hage R, Merle H. Third Cranial Nerve Palsy in the Setting of Chikungunya Virus Infection. Am J Trop Med Hyg. 2016;95(1):180-1.,33 Costa AL, Martins TG, Martins DG. Third Cranial Nerve Palsy after a Chikungunya Virus Infection. Strabismus. 2017;25(4):172-5.).
Referências
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1Esporcatte LP, Portes AJ. Manifestações oculares na febre Chikungunya. Rev Bras Oftalmol . 2019;78(5):338-41.
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2Benzekri R, Hage R, Merle H. Third Cranial Nerve Palsy in the Setting of Chikungunya Virus Infection. Am J Trop Med Hyg. 2016;95(1):180-1.
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3Costa AL, Martins TG, Martins DG. Third Cranial Nerve Palsy after a Chikungunya Virus Infection. Strabismus. 2017;25(4):172-5.
Publication Dates
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Publication in this collection
03 June 2020 -
Date of issue
Mar-Apr 2020