Ocular Findings in Patients with Crimean-Congo Hemorrhagic Fever

Abstract

PURPOSE: To describe ocular findings of patients with Crimean-Congo hemorrhagic fever (CCHF). DESIGN: Prospective, interventional, consecutive case series. METHODS: This study was conducted in Sivas, a city located in the central Anatolia, between July 1 and August 31, 2007. Confirmed CCHF patients were enrolled in the study and underwent ocular examination during hospitalization. RESULTS: Nineteen confirmed CCHF patients were included in this study. All patients were classified into 2 groups in terms of disease severity (severe vs nonsevere), according to the Swanepoel predictive criteria. Fourteen patients (73.7%) were classified as "nonsevere," and the remaining 5 patients (26.3%) were classified as "severe" in this study. One patient having severe disease died. Ocular findings were present in 14 patients (73.7%) and none of the patients presented any visual complaints. Ocular examination revealed that 7 patients (36.8%) had only bilateral multiple subconjunctival hemorrhage, and 2 patients (10.5%) (1 bilateral, I unilateral) had retinal hemorrhage. Five patients (26.3%) had subconjunctival hemorrhage and retinal hemorrhage. Follow-up examination 1 month later showed complete resorption of the subconjunctival hemorrhage and retinal hemorrhage. There was a statistically significant difference between patients with ocular findings and patients without ocular findings for prothrombin time (P = .011). There was no evidence of uveitis, retinal edema, sheathing of retinal vessels, or intravitreal hemorrhage in our patients. CONCLUSION: From the small sample study, CCHF caused a mild form of ocular disease. CCHF must be considered when subconjunctival or superficial retinal hemorrhages are seen in association with fever in endemic areas. (Am J Ophthalmol 2009;147:634-638. (C) 2009 by Elsevier Inc. All rights reserved.)