Lyme disease and optic neuritis: Long-term follow-up of seropositive patients

Lyme optic neuritis

“…Among 20 patients with suspected isolated or non-isolated Lyme ON in the literature including ours, 13 had a positive response to antibiotherapy [8,16]. Furthermore, all six patients with a positive AI had a good outcome with antibiotherapy [6,7]. Corticosteroid treatment seems to be only partially effective [8].…”

“…However, one study demonstrated the positivity of AI in 26.2% in a cohort of 42 MS patients, using a commercial kit of sandwich enzyme immunoassay (Test-Line Ltd, Clinical Diagnostics) different from the kit used for the two patients here [21]. In two previous studies of ON, with systematic screening for Lyme disease, four patients also had strong arguments in favor of isolated Lyme ON [6,7]. In the first study, 25 out of 440 patients with ON had positive Lyme serology and two of these patients had a positive specific AI [6], giving an overall prevalence of Lyme ON of 0.5%.…”

“…In the second study, four patients had positive Lyme serology. Two of these patients had a negative specific AI and subsequently developed multiple sclerosis, and the other two had specific AI and Lyme ON [7]. In these two studies, the four patients with Lyme ON were treated with antibiotics with a good outcome.…”

“…ON has been described in association with meningoradiculitis and chronic encephalomyelitis in two large neuroborreliosis cohorts [3,4], using European criteria for the diagnosis of neuroborreliosis [5]. Isolated forms -without any other neurological symptoms -of Lyme ON are rare, but at least four cases have been described [6][7][8]. We describe two new cases and discuss this rare clinical entity.…”

Ocular manifestations of Lyme borreliosis in Europe

“…The long-term follow-up of four cases of optic neuritis labelled as Lyme disease because of the positive serology for Borrelia revealed that three patients actually developed demyelinating syndromes. 5…”