Study Identifies Distinct Retinal Disease Pattern in Pediatric Vision Loss after Fever

A study finds a distinct retinal disease pattern in children with sudden vision loss after fever, showing significant recovery in most cases within a year.

A recent study published in JAMA Ophthalmology highlighted a distinctive pattern of pediatric retinal disease that could help streamline diagnosis and prognosis for children who experience sudden, severe bilateral vision loss following a fever. The study focused on eight pediatric patients who developed sudden vision loss, nyctalopia, and visual field constriction, along with characteristic disruptions in the ellipsoid zone (EZ) and external limiting membrane (ELM) of the retina.  

The multicenter case series, conducted between November 2022 and May 2023, involved 16 eyes from children aged 3 to 7 years. All patients exhibited a sudden loss of vision a mean of 16 days after the onset of fever. Despite initial severe symptoms and a baseline visual acuity mostly below counting fingers, the patients showed substantial recovery in visual acuity over the course of a year. At follow-up, 88% achieved 20/40 vision or better, with half of them achieving 20/25 or better.  

The study found that although the macular EZ and ELM largely recovered, extrafoveal regions remained affected. Electroretinography (ERG) indicated extinguished responses in all patients, despite improvements in visual acuity.