ro13-9904 and Eye-Diseases

Topics: Anti-Bacterial Agents; Ceftazidime; Ceftriaxone; Doxycycline; Eye; Eye Diseases; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Young Adult

To delineate the clinical manifestations of ocular Lyme borreliosis, while concentrating on new symptoms and findings and the phase of appearance of ophthalmologic disorders.. Observational case series.. Ten patients with Lyme borreliosis-associated ophthalmologic findings previously reported from the Helsinki University Central Hospital in addition to 10 new cases that have since been diagnosed. INTERVENTION/TESTING: The patients underwent medical and ophthalmologic evaluation. The diagnosis of Lyme borreliosis was based on medical history, clinical ocular and systemic findings, determinations of antibodies to Borrelia burgdorferi by enzyme-linked immunosorbent assay and immunoblot analysis, the detection of DNA of B. burgdorferi by polymerase chain reaction, and exclusion of other infectious and inflammatory causes.. Ocular complaints, presenting ophthalmologic findings, and the stage of Lyme borreliosis were recorded.. Four patients presented with a neuro-ophthalmologic disorder, five had external ocular inflammation, 10 patients had uveitis, and one had branch retinal vein occlusion. One patient developed episcleritis and one patient developed abducens palsy within 2 months of the infection incident. In the remaining 14 patients in whom the time of infection was traced, the ocular manifestations appeared in the late stage of Lyme borreliosis. Two patients with a neuro-ophthalmologic disorder and one with external ocular inflammation experienced severe photophobia, whereas the main reported symptom of the patients with uveitis was decreased visual acuity. Four patients with external ocular disease and one with a neuro-ophthalmologic disorder experienced severe periodic ocular or facial pain. Retinal vasculitis developed in seven patients with uveitis.. Lyme borreliosis can cause a variety of ocular manifestations, which develop mainly in the late stage of the disease. Photophobia and severe periodic ocular pain can be characteristic symptoms of Lyme borreliosis. In the differential diagnosis of retinal vasculitis, Lyme borreliosis should be taken into account, especially in endemic areas.

Topics: Adult; Aged; Antibodies, Bacterial; Borrelia burgdorferi Group; Ceftriaxone; Cephalosporins; DNA, Bacterial; Enzyme-Linked Immunosorbent Assay; Eye Diseases; Eye Infections, Bacterial; Female; Humans; Lyme Disease; Male; Middle Aged; Polymerase Chain Reaction; Visual Acuity

Twelve patients with intraocular Lyme borreliosis suffering from vitreitis were treated with ceftriaxone intravenously. Eight patients had definitive Lyme borreliosis, and tentative diagnosis was made in four patients. After treatment with ceftriaxone, all 12 patients were followed up for more than one year. Vitreitis diminished in all patients and visual acuity improved in six patients. The best results were achieved in patients with definitive Lyme borreliosis.

Topics: Adult; Antibodies, Bacterial; Borrelia burgdorferi Group; Ceftriaxone; Eye Diseases; Eye Infections, Bacterial; Female; Follow-Up Studies; Humans; Immunoglobulin G; Infusions, Intravenous; Longitudinal Studies; Lyme Disease; Male; Middle Aged; Treatment Outcome; Visual Acuity; Vitreous Body

Four patients from Caribbean and Central American countries with ocular disease and serologic evidence of Lyme borreliosis are discussed. To our knowledge this is the first report of Lyme disease from this geographic area. Two patients exhibited ocular inflammatory disease, and two patients developed optic neuropathy. A brief discussion of Lyme borreliosis, its serologic diagnosis, and its treatment is presented.

Topics: Adult; Aged; Borrelia Infections; Ceftriaxone; Child; Endophthalmitis; Eye Diseases; Humans; Intraocular Pressure; Lyme Disease; Male; Middle Aged; Optic Nerve Diseases; Penicillins; Tetracycline; Visual Acuity; West Indies