1Assistant Professor, Dept. of Ophthalmology, Hassan Institute of Medical Sciences, Karnataka, India
2Junior Resident, Dept. of Ophthalmology, Hassan Institute of Medical Sciences, Karnataka, India
3Professor and HOD, Dept. of Ophthalmology, Hassan Institute of Medical Sciences, Karnataka, India
4Junior Resident, Dept. of Ophthalmology, Hassan Institute of Medical Sciences, Karnataka, India
*Corresponding Author: Email: lakshmibr24@gmail.com
Online published on 14 January, 2019.
To describe fundus manifestations following typhoid fever and their response to systemic steroids.
A retrospective study was done on 14 patients during April 2015-Feb 2016 presenting with complaints of diminution of vision with history of typhoid fever 4–6 weeks ago. All patients underwent a detailed ophthalmic evaluation. OCT and FFA were done when considered relevant. TC/DC/ESR/HIV and Widal tests were done. Oral prednisolone, 1mg/kg/day was given and tapered over a period of 6 weeks.
21 eyes of 14 patients presenting with visual complaints following typhoid fever were studied. At presentation, vision was <1/60 in 2 eyes, 1/60-3/60 in3 eyes.3/60 to 6/60 in 12 eyes and 6/60-6/12 in 4 eyes. Fundus manifestations included disc involvement in 15eyes, Retinitis patches in 19 eyes, Vasculitis in 12 eyes and macular edema/star/detachment in 17 eyes. All the findings were confined to the posterior pole. All patients responded well to steroids. Patients with bilateral confluent retinitis had significantly high Widal titres. Final vision ranged between 6/12-6/60.
Even though a less documented entity, one can encounter non-infectious immune mediated retinitis after typhoid fever. This study highlights the need for a high index of suspicion to diagnose this condition and early institution of steroids for better visual outcome.
Steroids, Post-febrile neuroretinitis, Typhoid, Post-typhoid retinitis, Widal titres
