Lyme disease associated neuroretinitis - Case report.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Neurology

Background:

• Lyme disease, caused by Borrelia burgdorferi, can present with rare neurological complications.
• Neuroretinitis, inflammation of the optic nerve and retina, is an uncommon manifestation of Lyme disease.

Observation:

• A 27-year-old woman presented with unilateral blurred vision and optic nerve swelling.
• Ophthalmological examination revealed optic nerve swelling and retinal edema in the right eye.
• Brain CT showed an incomplete empty sella, a finding typically associated with bilateral optic nerve swelling.

Findings:

• Blood tests confirmed Lyme disease (Borrelia burgdorferi sensu lato).
• Optical coherence tomography (OCT) confirmed optic nerve head swelling and retinal edema.
• Visual evoked potentials (VEP) showed minimal differences between the eyes.

Implications:

• Unilateral neuroretinitis due to neuroborreliosis is a rare complication of Lyme disease.
• Distinguishing between inflammatory and ischemic causes of visual disturbance can be challenging.
• Intracranial findings like empty sella can complicate the diagnostic process.