Unilateral dengue-associated neuroretinitis: a case report

Abstract

Abstract We report a rare case of unilateral neuroretinitis associated with dengue infection in a 33-year-old man presenting with acute visual loss in the right eye following a febrile illness acquired during travel to Thailand. Although ocular manifestations of dengue are well recognized, they are typically bilateral, making unilateral involvement uncommon. Ophthalmic examination revealed unilateral optic disc oedema, retinal thickening involving the macula, vitritis, and retinal haemorrhages. Optical coherence tomography demonstrated marked serous retinal detachment with significant central thickening, while fluorescein angiography confirmed optic disc and retinal vascular leakage consistent with neuroretinitis and retinal vasculitis in the affected eye. Extensive neurological and infectious work-up excluded alternative causes of neuroretinitis. Serological testing confirmed a pattern consistent with recent dengue infection. The patient was treated with systemic corticosteroids following exclusion of active phase of infection, resulting in rapid anatomical improvement and significant visual recovery, which remained stable at long-term follow-up. This case highlights that dengue-associated neuroretinitis may present unilaterally, and dengue infection should be considered in the differential diagnosis of posterior segment inflammation in returning travellers, even in atypical presentations.