Madan Upadhyay1, Ranju Kharel Sitaula2, Bharat Shrestha3, Bhaiya Khanal4, Bishnu Psd Upadhyay5, Jeevan B Sherchand6, Prakash Ghimire7. 1. a BP Eye Foundation, Community Hospital for Children Eye, ENT and Rehabilitations Services (CHEERS) , Kathmandu , Nepal. 2. b Department of Ophthalmology, Maharajgunj Medical Campus B. P. Koirala Lions Centre for Ophthalmic Studies, Tribhuvan University, Institute of Medicine , Kathmandu , Nepal. 3. c Ophthalmology Department, Royal Eye Infirmary, Derriford Hospital , Plymouth , United Kingdom. 4. d Natural History Museum, Tribhuvan University , Kathmandu , Nepal. 5. e Bio-safety Lab, National Public Health Laboratory , Teku , Kathmandu , Nepal. 6. f Department of Clinical Microbiology, Public Health Research Laboratory, Tribhuvan University Teaching Hospital, Institute of Medicine , Kathmandu , Nepal. 7. g Central Department of Microbiology, Tribhuvan University , Kathmandu , Nepal.
Abstract
Purpose: This review aims to provide a detailed update in Seasonal hypercute panuveitis (SHAPU) which is a blinding disease of unknown etiology reported only from Nepal, occurring every odd year since 1975 predominantly in children. Methods: Data sources were literature reviewed using PubMed, Medline, and ISI Databases (since 1975 to late 2017). Search items included SHAPU, seasonal endophthalmitis, hypopyon uveitis, caterpillar induced uveitis alone or in combination with white moth, panuveitis, and review. Results: Epidemics of SHAPU occur between August to December usually in odd years. Two thirds of the children present with unilateral blind eye which eventually becomes soft with shallowing of anterior chamber called as Malignant Hypotension. Hypopyon, fibrinous exudates in anterior chamber, difficult to dilate pupil and inability to visualize the retina because of massive exudation into vitreous producing a "White pupil in a Red eye" with little or no pain is its characteristic features. Contact with moths has been suspected. Because of presence of microbial agents in few cases, an infectious etiology has not been ruled out. Conclusions: Although SHAPU has been reported only from Nepal, lack of its report from ecologically similar terrain along Hindukush Mountains and possible association with moths remain intriguing.
Purpose: This review aims to provide a detailed update in Seasonal hypercute panuveitis (SHAPU) which is a blinding disease of unknown etiology reported only from Nepal, occurring every odd year since 1975 predominantly in children. Methods: Data sources were literature reviewed using PubMed, Medline, and ISI Databases (since 1975 to late 2017). Search items included SHAPU, seasonal endophthalmitis, hypopyon uveitis, caterpillar induced uveitis alone or in combination with white moth, panuveitis, and review. Results: Epidemics of SHAPU occur between August to December usually in odd years. Two thirds of the children present with unilateral blind eye which eventually becomes soft with shallowing of anterior chamber called as Malignant Hypotension. Hypopyon, fibrinous exudates in anterior chamber, difficult to dilate pupil and inability to visualize the retina because of massive exudation into vitreous producing a "White pupil in a Red eye" with little or no pain is its characteristic features. Contact with moths has been suspected. Because of presence of microbial agents in few cases, an infectious etiology has not been ruled out. Conclusions: Although SHAPU has been reported only from Nepal, lack of its report from ecologically similar terrain along Hindukush Mountains and possible association with moths remain intriguing.