登革热的眼部表现：系统回顾和荟萃分析。

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-08-15 DOI:10.1016/j.ajo.2025.08.021

Alden Xavier Haslam , Maria del Mar Tiffer Blandón , Andrea Sarahí Rodríguez Castro

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引用次数: 0

摘要

主题：尽管有威胁视力的并发症报道，但登革热的眼部表现仍未得到充分认识。本系统综述和荟萃分析旨在确定登革热患者眼部表现的总体患病率，描述其频谱、频率和临床意义。临床意义：登革热影响全球数百万人，主要在热带地区。虽然系统性并发症有充分的记录，但眼部受累的定义仍然不明确，患病率估计不一，危险因素不明确。早期识别对于及时干预至关重要，特别是在临床怀疑程度低的流行地区。方法：在PubMed、CINAHL和LILACS中进行综合检索。符合条件的研究包括报告登革热患者眼部表现患病率的观察性研究。使用Hoy等人的流行病学研究工具评估偏倚风险。使用随机效应模型计算合并患病率估计值，并使用I2统计量评估异质性。结果：共纳入32项研究，11426例患者。从16项研究中计算得出，眼部症状的总患病率为0.32 （95% CI: 0.22-0.45, I2 = 91.8%）。眼后疼痛的总患病率为0.20 (95% CI: 0.10-0.37, I2 = 99.6%)，而视力模糊的总患病率为0.11 （95% CI: 0.05-0.23, I2 = 92.8%）。在结构性表现中，结膜下出血发生率为0.18 (95% CI: 0.10-0.30, I2 = 94.1%)，视网膜出血发生率为0.08 (95% CI: 0.05-0.12, I2 = 77.8%)，黄斑病变发生率为0.04 (95% CI: 0.02-0.08, I2 = 91.6%)，葡萄膜炎发生率为0.05 （95% CI: 0.01-0.24, I2 = 97.4%）。研究中观察到显著的异质性，可能是由于诊断标准、研究人群和疾病严重程度的差异。结论：本研究强调了登革热患者眼部表现的普遍存在，强调了提高临床意识的必要性，特别是在流行地区。鉴于报告患病率的异质性，未来的研究应侧重于前瞻性、标准化的眼科评估，以提高早期诊断和管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Ocular manifestations in Dengue Fever: A Systematic Review and Meta-Analysis

Topic

Ocular manifestations in dengue fever remain underrecognized despite reports of vision-threatening complications. This systematic review and meta-analysis aimed to determine the pooled prevalence of ocular manifestations in dengue patients, characterizing their spectrum, frequency, and clinical significance.

Clinical Relevance

Dengue fever affects millions globally, predominantly in tropical regions. While systemic complications are well documented, ophthalmic involvement remains poorly defined, with variable prevalence estimates and unclear risk factors. Early recognition is crucial for timely intervention, particularly in endemic areas where clinical suspicion is low.

Methods

A comprehensive search was conducted in PubMed, CINAHL, and LILACS. Eligible studies included observational studies reporting the prevalence of ocular manifestations in dengue patients. Risk of bias was assessed using Hoy et al.’s tool for prevalence studies. Pooled prevalence estimates were calculated using a random-effects model, and heterogeneity was assessed using I² statistics.

Results

A total of 32 studies, including 11,426 patients, were included. The pooled prevalence of ocular manifestations, calculated from 16 studies, was 0.32 (95% CI: 0.22–0.45, I² = 91.8%). Retro-ocular pain had a pooled prevalence of 0.20 (95% CI: 0.10–0.37, I² = 99.6%), while blurred vision was reported in 0.11 (95% CI: 0.05–0.23, I² = 92.8%). Among structural manifestations, subconjunctival hemorrhage had a prevalence of 0.18 (95% CI: 0.10–0.30, I² = 94.1%), retinal hemorrhage 0.08 (95% CI: 0.05–0.12, I² = 77.8%), maculopathy 0.04 (95% CI: 0.02–0.08, I² = 91.6%), and uveitis 0.05 (95% CI: 0.01–0.24, I² = 97.4%). Significant heterogeneity was observed across studies, likely due to differences in diagnostic criteria, study populations, and disease severity.

Conclusion

This study highlights a substantial prevalence of ocular manifestations in dengue patients, emphasizing the need for increased clinical awareness, particularly in endemic regions. Given the heterogeneity in reported prevalence, future research should focus on prospective, standardized ophthalmologic assessments to improve early diagnosis and management.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.