Inflammatory choroidal neovascular membrane in presumed ocular Lyme borreliosis

Abstract

. Introduction: Lyme disease is a multisystemic disease with protean ocular manifestations. We describe the occurrence of inflammatory choroidal neovascular membrane (CNVM) in two patients suffering from presumed Lyme disease. Methods: Descriptive review of the clinical records of two patients. Results: Patient 1: 16‐year‐old healthy male presenting with a visual acuity of counting fingers [oculus dexter (OD)] and 6/6 [oculus sinister (OS)] 3 months after a tick bite. He had papillitis and an exudative subretinal macular lesion OD. Treatment was started with intravenous (IV) ceftriaxone; a week later, IV methylprednisolone was administered with a tapering dose of oral steroids thereafter. Three months later, VA had improved to 3/60 OD. Patient 2: 38‐year‐old healthy female presenting with reduced left‐eye vision (6/24) 6 weeks after a tick bite. She also suffered from erythema migrans and arthralgias. She had left‐eye papillitis, macular haemorrhages and vascular sheathing. Treatment was started with IV ceftriaxone. One month later, there was profound loss of vision with development of CNVM. Treatment was declined by the patient and eventually retinal fibrosis developed. Conclusion: Inflammatory CNVM has not been described previously in the setting of ocular Lyme borreliosis. We herein describe the occurrence of inflammatory CNVM in two patients whose diagnosis with Lyme disease was clinically based – both were sero‐negative. Visual outcome in the two patients was profoundly impaired because of the ensuing macular scar.

Lyme disease atypically presenting with a singular symptom: Unilateral chorioretinitis

“…In this case, travel to the endemic region and a history of ECM lesion was present. In the case reports by Amer et al, 7 one of the two patients with chorioretinitis had an EM clinic, and both had a history of tick bites, but serological tests were negative for Borreliosis. Although serological results were negative, the history of ECM and tick bites facilitated the diagnosis of the patients.…”

Optic Neuritis in Acute Neuroborreliosis (Lyme Disease) in the U.S.-Mexican Border: Case Report

“…Additional case in 1996, where a patient with bilateral Lyme papillitis had been suffering with back pain for several months [9]. Two additional patients with presumed LD based on clinical findings presenting with papillitis have shown improvement following administration of intravenous methylprednisolone and ceftriaxone [10].…”

Ophthalmological findings in neuroborreliosis – a prospective study performed in western Sweden

“…The ophthalmological symptoms and findings in patients with neuroborreliosis may vary considerably and, except for case studies (Amer et al. ; Sauer et al. ), there are not many studies that profoundly investigate ocular involvement in these patients (Zaidman ; Mora & Carta ).…”