Related Experiment Videos
Reactive Lyme serology in optic neuritis.
Patrick Sibony1, John Halperin, P K Coyle
1Department of Ophthalmology and Neurology, State University of New York at Stony Brook, Stony Brook, NY 11794, USA. psibony@notes.cc.sunysb.edu
Summary
Establishing a causal link between Lyme disease (LD) and optic neuritis is difficult due to diagnostic limitations. This study found insufficient evidence for LD causing retrobulbar optic neuritis or neuroretinitis, but sufficient evidence for papillitis and posterior uveitis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Neuroscience
Background:
- Establishing a causal relationship between Lyme disease (LD) and optic neuritis is challenging due to serologic diagnostic limitations.
- Despite challenges, optic neuritis is often perceived as a common manifestation of LD.
Purpose of the Study:
- To investigate the association between Lyme disease serology and optic neuritis.
- To determine if LD is a cause of various forms of optic neuritis.
Main Methods:
- Retrospective analysis of Lyme serology in 440 patients with optic neuritis.
- Study conducted in a region hyper-endemic for LD between 1993 and 2003.
Main Results:
- Lyme enzyme-linked immunosorbent assay (ELISA) was positive in 6.4% of patients.
- Only one case of optic neuritis was confidently attributed to LD (papillitis).
- Most positive serologies were weak, with negative Western blots, indicating no current LD infection.
Conclusions:
- Insufficient evidence links LD to retrobulbar optic neuritis or neuroretinitis.
- Sufficient evidence supports a causal link between LD and papillitis.
- Sufficient evidence supports a causal link between LD and posterior uveitis.