Effect of Dengue Infection on the Severity and Progression of Diabetic Maculopathy

Abstract

Background: Diabetic maculopathy is a vision-threatening complication of diabetes mellitus, often influenced by systemic factors. Recent evidence suggests that systemic infections, including dengue virus (DENV), may exacerbate retinal vascular pathology, but the ocular impact of dengue in patients with diabetic maculopathy remains underexplored. The aim of this study was to evaluate the effect of dengue infection on the severity and progression of diabetic maculopathy.

Methods: This cross-sectional observational study was conducted in Departments of Community Ophthalmology and Ophthalmology, Bangladesh Medical University (BMU) and Bangladesh Eye Hospital, Malibagh, from January 2025 to June 2025. Total 60 participants with diagnosed diabetic maculopathy who had laboratory-confirmed dengue infection during or within two weeks prior to ophthalmic presentation were include in this study.

Result: The majority of patients had diabetes for 5–10 years, with common comorbidities including hypertension (63.3%) and smoking (36.7%). Diffuse diabetic macular edema was the most frequent maculopathy type (38.33%), followed by ischemic (31.67%) and focal edema (26.67%). Mean HbA1c was 8.7%, indicating poor glycemic control. Central macular thickness significantly decreased over three months (p = 0.032), and BCVA improved (≥6/12: 23.3% to 36.7%, p = 0.032). Visual acuity <6/60 dropped to 10% (p = 0.040). However, ischemic maculopathy increased slightly, and anti-VEGF therapy use rose from 18.3% to 31.7% during follow-up.

Conclusion: This study suggests that dengue infection may worsen diabetic maculopathy, especially in patients with poor glycemic control and comorbidities. Despite improvements in macular thickness and vision, ischemic changes showed minimal reversal, highlighting complex vascular interactions.