Intraocular pressure changes in nephropathia epidemica. A prospective study of 37 patients with acute systemic Puumala virus infection.

BACKGROUND

Nephropathia epidemica is a zoonose in the group of hemorrhagic fevers with renal syndrome and is caused by Puumala virus in Hantavirus genus. The purpose of this study is to find out how the intraocular pressure (IOP) is affected by the acute phase of this disease and how it relates to the previous case reports on angleclosure glaucoma attacks.

PATIENTS AND

METHODS

The prospective study documents IOP and anterior chamber depth measurements in 37 patients during the winter epidemic of nephropathia epidemica from 1992 to 1993. Ocular examinations were performed during the acute systemic infection and after clinical recovery.

RESULTS

The IOP was lower and the anterior chamber shallower in the acute phase than after the clinical recovery of nephropathic epidemica. The mean differences in IOP were 1.8 mmHg in the right eye and 1.9 mmHg in the left (P < 0.001) and the mean differences in the anterior chamber depth were 0.22 mm in the right eye and 0.20 mm in the left (P < 0.001). No acute angle-closure attacks with highly elevated IOP were encountered in this study. The mean IOP did not rise higher than 14.3 mmHg in both eyes after the clinical recovery of systemic infection.

CONCLUSION

In contradistinction to earlier assumptions, Puumala virus infection decreases the IOP. Shallowing of anterior chamber and narrowing of the anterior chamber angle in the acute phase of nephropathia epidemica did not lead to angle-closure attacks in this series.