Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Theiler, G.
Ocular Characteristics of Patients with Nephropathia epidemica in Austria
[ Diplomarbeit ] Medical University of Graz; 2010. pp. 74
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Krause Robert
- Langner-Wegscheider Beate Julia
- Altmetrics:
- Abstract:
- Background: Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome caused by the Puumala virus carried by the bank vole. Renal involvement is prominent. Apart from a variety of unspecific symptoms ocular manifestations are reported. Especially blurred vision due to myopic shift is a pathognomonic sign for Puumala virus infection. There is no epidemiological data concerning Nephropathia epidemica and ocular manifestations confirmed by ophthalmic examination in Austria so far. Aim of the study: As the percentage of ocular involvement varies in different European countries the aim of this study was to describe the occurrence of ophthalmic symptoms in southeast Austria and to investigate whether there is a correlation between ocular involvement and clinical findings and laboratory parameters. Methods: Between April 2003 and March 2009 18 patients with Nephropathia epidemica treated at the university hospital of Graz, Austria, located in the endemic area of Styria and Carinthia, underwent ophthalmic examination. Data were analyzed retrospectively regarding myopic shift, subjective blurred vision and conjunctival changes. Furthermore, ophthalmic results were compared with clinical and laboratory parameters. Results: In 9 patients (50%) myopic shift was diagnosed. The average myopic shift was -2.75 diopters (calculated from the measurements in 5 patients) in the right eye and -2.54 diopters (calculated from the measurements in 6 patients) in the left eye. Furthermore, 4 patients without detected myopic shift had blurred vision before ophthalmic examination. 4 of 17 patients (23.5%) had conjunctival injection, one patient had conjunctival hemorrhages. There was no correlation between the occurrence of myopic shift and parameters such as CRP and levels of creatinine and thrombocytopenia. All patients recovered from the disease, myopia regressed in all cases. Conclusion: The results show that ocular involvement is not uncommon in NE in Austria. Myopic shift occurs independently from the severity of the clinical course. Myopic shift and/or conjunctival involvement can be an important hint leading to the diagnosis of Puumala virus infection.