Lyme borreliosis: different ocular aspects of the same disease in North‐West of Italy

Abstract

Abstract Purpose To show different presentations of ocular Lyme disease in an endemic area (North‐West of Italy) Methods In last ten years, at Lavagna (Genova) uveitis referral centre, we examined about a hundred people affected by Lyme ocular disease (57 males and 45 females; mean age 42 +/‐ 3.2 years) and we were able to recognize some different ocular manifestations of this affection in 133 eyes. Diagnosis was made by means of ELISA or Western‐Blot tests;sometimes by PCR test. Different systemic symptoms were present: 53% of patients had inflammatory arthropathy, 24% erythema migrans, 13% neuro‐ophthalmologic findings. Results Five main groups of Lyme disease ocular involvement were detected from our long‐term study: 1 ‐ diplopia and periocular pain 2 ‐ diffuse or nodular episcleritis 3 ‐ acute anterior uveitis 4 ‐ retinal vasculitis and papillitis 5 ‐ retino‐choroiditis Group 4 and 5 were the more frequent bilateral presentation. Our study shows slit‐lamp, FA, ICG‐A and OCT pictures of these different Lyme disease presentations. Antibiotic treatment of early diagnosed infection allowed a complete recovery in 79 patients. Conclusion Lyme ocular disease, because of its peculiar characteristic of being able to mimic a lot of ocular inflammations, may be underdiagnosed by ophthalmologists; aim of our work is to show and to point out some different ocular presentations of this disease