Indian Journal of Ophthalmology (Jan 2017)

Neuroretinitis as presenting and the only presentation of Lyme disease: Diagnosis and management

  • Brahm Prakash Guliani,
  • Sandeep Kumar,
  • Neha Chawla,
  • Anuj Mehta

DOI
https://doi.org/10.4103/ijo.IJO_151_17
Journal volume & issue
Vol. 65, no. 3
pp. 250 – 252

Abstract

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We present a case of neuroretinitis as presenting and the only presentation of Lyme disease in a 25-year-old female who visited hilly areas in the Himalayas of North India. She presented with right eye sudden and painless blurring of vision. Her vision at presentation was 20/60. She had fundus examination; fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) imaging showed classical features of neuroretinitis. No other organ was involved. Oral steroids were prescribed and relevant investigations sent for noninfective and infective causes. Worsened visual acuity (VA) to hand movement and positive IgM titers for Borrelia burgdorferi led to the diagnosis of Lyme disease-associated neuroretinitis. Treatment with oral doxycycline plus oral steroids for 4 weeks revealed VA of 20/20 and resolution of fundus and OCT changes. Neuroretinitis as presenting and the only presentation of Lyme disease will be discussed with serial fundus, FFA, and OCT pictures.

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