Clinical Features of Post Fever Retinitis and Visual Outcomes with Oral Corticosteroids: A Retrospective Study

Abstract

Introduction: Post Fever Retinitis (PFR) is an infectious or parainfectious uveitis presenting with visual impairment after a fever episode. The condition can cause potential visual impairment in these patients. There is no national guideline for treatment of PFR. Hence, there is a need to study the clinical features and visual outcomes with the use of corticosteroid therapy. Aim: To describe the clinical features of patients presenting with PFR and visual outcome with the oral corticosteroid therapy. Materials and Methods: This retrospective study conducted in the Outpatient Department (OPD) of Ophthalmology at SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India. The duration of the study was 35 months, from January 2019 to December 2021. A total of 23 eyes of 13 patients treated with oral corticosteroids were included. Data collected included patients’ demographic details including name, age, sex, hospital identification number, duration of vision loss, detailed ophthalmic examination findings, including visual acuity testing with Snellen’s chart, slit lamp examination findings and fundus examination findings including detailed fundus drawings, Optical Coherence Tomogram (OCT) and fundus photographs. Visual Acuity (VA) at the time of presentation and after steroid therapy were recorded. Data was entered in microsoft excel spreadsheet and descriptive analysis was done. Results: Age of the study participants ranged from 15 years to 52 years with an average of 29.6 years. A total of 23 eyes of 13 patients were included in the present study. At the time of presentation, two eyes had visual acuity better than 6/12 on Snellen’s chart. Five eyes had mild vision impairment, five eyes had moderate vision impairment and eleven eyes had vision <3/60, according to the visual impairment classification of World Health Organisation (WHO). Macular oedema was the other most common finding seen in 12 (52.17%) eyes. All the patients showed beginning of resolution of retinitis by 2-3 weeks after starting oral corticosteroids. A total of 23 eyes, 8 (34.7%) eyes recovered vision >6/12, out of which 6 eyes (26.08%) recovered with 6/6 vision. Conclusion: PFR affects predominantly young immunocompetent individuals. Treatment outcomes with oral steroids is found to be satisfactory