Optic neuritis associated with chikungunya virus infection in South India

Arch Ophthalmol. 2007 Oct;125(10):1381-6. doi: 10.1001/archopht.125.10.1381.

Abstract

Objective: To define optic neuritis associated with chikungunya virus (CHIKV) infection in a clinical setting.

Methods: This observational case series includes 14 patients with clinical features of CHIKV infection and associated optic neuritis. Complete ophthalmic evaluations were performed, as well as other examinations, including Mantoux test, Widal test, blood profile, color vision, neuroimaging, visual fields, visual evoked potentials, VDRL test, and enzyme-linked immunosorbent assay for CHIKV-specific immunoglobulin. Relevant clinical findings of optic neuritis associated with seropositive CHIKV infection were recorded.

Results: Nineteen eyes (in 14 patients) had optic nerve involvement. The mean +/- SD patient age was 45.8 +/- 15.6 years. Eight eyes (42%) had papillitis, 4 eyes (21%) had retrobulbar neuritis, 4 eyes (21%) had retrochiasmal (optic tract) neuritis, and 3 eyes (16%) had neuroretinitis. Parenteral corticosteroids were administered in all patients. Color vision, visual fields, and best-corrected visual acuity of 6/12 (or 20/40 Snellen visual acuity) or better improved statistically significantly by the end of 3 weeks (P < .001). Partial to complete recovery of visual function was seen in 10 patients (71%). Four patients had a poor visual outcome; 3 of them were initially seen 1 month after onset of ocular symptoms.

Conclusions: Acute-onset visual loss due to optic neuritis may be associated with CHIKV infection. Visual recovery is good. Corticosteroids accelerated recovery when initiated at an early stage of the disease.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Alphavirus Infections / diagnosis
  • Alphavirus Infections / drug therapy
  • Alphavirus Infections / virology*
  • Antibodies, Viral / blood
  • Chikungunya virus / immunology
  • Chikungunya virus / isolation & purification*
  • Color Perception
  • Enzyme-Linked Immunosorbent Assay
  • Evoked Potentials, Visual
  • Eye Infections, Viral / diagnosis
  • Eye Infections, Viral / drug therapy
  • Eye Infections, Viral / virology*
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin M / analysis
  • India
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Optic Neuritis / diagnosis
  • Optic Neuritis / drug therapy
  • Optic Neuritis / virology*
  • Vision Disorders / diagnosis
  • Vision Disorders / drug therapy
  • Vision Disorders / virology
  • Visual Fields

Substances

  • Antibodies, Viral
  • Glucocorticoids
  • Immunoglobulin M
  • Methylprednisolone