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Ophthalmic Images
June 11, 2015

Frosted Branch Angiitis in a Patient Coinfected With Dengue Hemorrhagic Fever and Malaria

Author Affiliations
  • 1Srimati Kannuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, Telangana, India

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Ophthalmol. 2015;133(6):e1568. doi:10.1001/jamaophthalmol.2015.68

A man in his 30s, who was known to be coinfected with dengue hemorrhagic fever and malaria for a duration of 20 days, presented with sudden onset of defective vision in his left eye for a duration of 10 days. The results of serologic testing were positive for IgM antibodies to dengue virus, and his peripheral blood smear showed malarial parasites. His visual acuity was hand motion in the left eye.

A fundus photograph of the left eye revealed multiple intraretinal hemorrhages, vascular sheathing typical of frosted branch angiitis, and macular edema (Figure). The patient received an intravitreal bevacizumab injection in the left eye for the management of macular edema. At the 4-month follow-up, his visual acuity improved to counting fingers (at 1 m) in the left eye, and a fundus examination of the left eye revealed the partial resolution of the hemorrhages, vascular sheathing typical of frosted branch angiitis, and the resolution of macular edema.