Optic Nerve Lesion following Neuroborreliosis: A Case Report

Burkhard, C; Gleichmann, Marc; Wilhelm, Helmut

doi:10.1177/112067210101100221

Cited by 11 publications

(9 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12 In both pathophysiologic processes, vasculopathic disease could be an underlying cause. 13,14 In the literature, various optic neuropathies have been attributed to LNB, for example papilledema, ischemic optic neuropathies, and optic neuritis, including papillitis, retrobulbar neuritis, and neuroretinitis. 15 However, different authors apply different criteria for an association with LNB, and in many cases, there may be insufficient evidence for an association with LNB if European (European Federation of Neurological Societies [EFNS]) and American (CDC) criteria for diagnosis of Lyme disease were to be applied.…”

Section: Discussionmentioning

confidence: 99%

A Child with Unilateral Visual Impairment Caused by Neuroborreliosis

Coenders

Portier

Geeraedts³

et al. 2018

J Pediatr Infect Dis

View full text Add to dashboard Cite

This case report describes a 7-year-old male patient with painless unilateral visual impairment due to optic neuropathy confirmed by visual evoked potentials (VEP), which was found to be attributed to neuroborreliosis. The diagnosis was confirmed by applying both European (European Federation of Neurological Societies [EFNS]) and American (Centers for Disease Control and Prevention [CDC]) criteria. Following intravenous treatment with broad-spectrum antibiotics, his vision gradually improved. This case report adds to the scarce evidence for an association between optic neuropathies and neuroborreliosis. It illustrates that, although uncommon, the clinician should be aware of the possibility of Lyme disease in patients with unilateral visual impairment due to optic neuropathy. Recognition is especially important because visual acuity can return to normal after adequate treatment. We reviewed the differences in criteria by the European EFNS guidelines and the American CDC criteria for making the diagnosis.

show abstract

Section: Discussionmentioning

confidence: 99%

A Child with Unilateral Visual Impairment Caused by Neuroborreliosis

Coenders

Portier

Geeraedts³

et al. 2018

J Pediatr Infect Dis

View full text Add to dashboard Cite

show abstract

“…In the recent literature the researchers discuss that patients with MS-like ocular symptoms probably had these symptoms due to MS and had also been exposed to the Borrelia bacterium. Based on the long-term follow-up of cases of isolated optic neuritis labeled as Lyme disease, because of the positive serology for Borrelia, there is an evidence for a later development of demyelination syndromes (8,9,10,13,14,15). The second patient suffered from serologically proven Lyme disease with isolated cystoid macular edema as a first manifestation.…”

Section: Discussionmentioning

confidence: 99%

“…Conjunctivitis is the most common ocular finding in stage I and II (3)(4)(5)(6). Ophthalmic complications can be associated with neurologic in-volvement, manifesting as ocular motility problems, optic neuritis, papilledema, and other possible ocular signs including uveitis, cystoid macular edema, scleritis, exudative retinal detachments (7)(8)(9)(10)(11)(12)(13)(14)(15). In the late stages of the Lyme borreliosis bilateral interstitial keratitis and symblepharon formation are described as characteristic findings.…”

Section: Introductionmentioning

confidence: 99%

Retrobulbar optic neuritis and cystoid macular edema as a first manifestation of lyme disease

Tzoukeva

Kaprelyan

Radkova

et al. 2014

SSM

View full text Add to dashboard Cite

Lyme disease is a multi-system disorder caused by the spirochete Borrelia burgdoferi. Eye manifestations are a rare involvement. We report two cases of patients who developed a retrobulbar optic neuritis and a cystoid macular edema as a sole clinical presenting in Lyme disease. A 42-year-old female presented with left eye decreased visual acuity and painful ocular movement. Dilated funduscopy and neurological examination were normal. A diagnosis of left eye retrobulbar optic neuritis was made. The brain and spinal cord MRI showed typical lesions characteristic of MS. Serological tests for Lyme disease revealed positive results for IgM ELISA and Western blot. The possible serologically proven Lyme disease was diagnosed. Visual acuity returned to normal following a course of high-dose steroids and intravenous antibiotic, after by oral antibiotic. A 28-year-old male presented with left eye blurred vision and intermittent blurring vision in his right eye. Dilated funduscopy revealed bilateral cystoid macular edema (left more than right). He was positive for Lyme serology, IgM ELISA and Western blot, and intravenous antibiotic therapy was commenced, followed by oral antibiotic. Visual acuity was restored and fuduscopy was normal. In summary, although Lyme disease is an uncommon cause of these neuro-ophthalmic complications, our two patients highlight the importance of considering this disorder as a differential diagnosis and to initiate an early adequate therapy.

show abstract

“…Tab. 2 Übersicht: wichtigste Zeichen einer primär demyelinisierenden NNO beim Erwachsenen (modifiziert nach Shams and Plant [51]).…”

Section: Nno Bei Sarkoidoseunclassified

Die Neuritis nervi optici

Gerth‐Kahlert¹,

Wermund²

2011

Klin Monatsbl Augenheilkd

View full text Add to dashboard Cite

The diagnosis of optic neuritis (ON) is made clinically based on typical signs and symptoms such as reduced vision and painful eye movements. Very often, ON is part of or associated with a systemic disease, in particular, multiple sclerosis (MS). Differential diagnosis is necessary in untypical cases with bilateral involvement, unusual age at manifestation or associated systemic and/or neurological symptoms. Neurological examination and cerebral MRI are standard in ON work-up. CSF analysis together with MRI scans allows MS risk assessment in ON patients. Further work-up is necessary in suspected systemic autoimmune disorders, sarcoidosis or infectious causes of ON such as borreliosis.

show abstract

Optic Nerve Lesion following Neuroborreliosis: A Case Report

Abstract: In optic nerve lesions due to neuroborreliosis it is difficult to distinguish between inflammatory and ischemic lesions. This patient demonstrated features of an ischemic optic nerve lesion.

Cited by 11 publications

References 10 publications

A Child with Unilateral Visual Impairment Caused by Neuroborreliosis

A Child with Unilateral Visual Impairment Caused by Neuroborreliosis

Retrobulbar optic neuritis and cystoid macular edema as a first manifestation of lyme disease

Die Neuritis nervi optici

Contact Info

Product

Resources

About