A 65-year old Asian–Indian presented with a month-old history of sudden, painless diminution of vision in both eyes (OD—20/200, OS—20/400). A nondiabetic, he had no history of hypertension or tuberculosis. He gave a history of fever and malaise associated with joint pain 1 week prior to onset of ocular symptoms. Left eye showed 2+ cells in the anterior chamber, while the right eye was quiet. No afferent pupillary defect was noted. Dilated fundus examination revealed neuroretinitis, cotton wool spots, hemorrhages, and a grade 2 vitreous haze in both eyes (a). Investigations for antinuclear antibodies, C-reactive protein, HIV, hepatitis B and C, Widal, Mantoux and QuantiFERON TB Gold were negative. The total leukocyte count and ESR were raised. Serum angiotensin-converting enzyme levels as well as platelet count were within normal limits. Reverse transcription polymerase chain reaction assay for Chikungunya performed on the patient's serum revealed 358 copies of RNA/μl (b). A diagnosis of Chikungunya neuroretinitis was made, and the patient was treated with oral steroids and oral acyclovir 800 mg five times a day for 3 weeks, after which partial resolution was noted (c).
Possible conflict of interest
Sankara Nethralaya, A Unit of Medical Research Foundation
This article is published under license to BioMed Central Ltd. Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.