Acute macular neuroretinopathy associates with dengue virus infection

Abstract

Acute macular neuroretinopathy (AMN) is a rare retinal condition characterized by paracentral scotomas and typical wedge-shaped lesions in the outer retina, often affecting young, otherwise healthy individuals. We report a case of AMN associated with dengue virus infection in a 48-year-old female doctor presenting with sudden onset of visual disturbances during a febrile illness after working away in Africa. Ophthalmologic examination and multi-modal imaging, including optical coherence tomography (OCT) and fundus autofluorescence(FAF), revealed characteristic outer retinal changes consistent with AMN. Dengue infection was confirmed through serologic testing, and no other systemic or ocular conditions were identified, apart from fever and myalgias.The pathophysiology of AMN in the context of dengue virus remains unclear, though it may involve ischemic damage to the deep retinal capillary plexus due to systemic inflammation, endothelial dysfunction, or immune-mediated mechanisms. This case under scores the importance of considering dengue virus infection in the differential diagnosis of AMNand/or foveolitis, particularly in endemic regions. Early recognition and diagnosis are critical for appropriate management and follow up, though no specific treatment for AMN exists.This case adds to the growing body of literature on the ocular manifestations of viral infections, specifically dengue, and highlights the need for further research into the underlying mechanisms and potential therapeutic interventions