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A Rare Cause of Optic Neuropathy
Isabel O Cruz1, Sara Alves Pereira2, Bruna Vieira3
1Internal Medicine, Hospital Pedro Hispano, Porto, PRT.
Cureus
|March 20, 2020
Summary
Lyme neuroborreliosis can cause vision loss and meningitis, even in treated patients. Early diagnosis and antibiotic treatment are crucial for preventing complications from this tick-borne illness.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Lyme disease, caused by Borrelia burgdorferi, is a tick-borne illness affecting multiple organ systems.
- Neurological complications, including meningitis and optic neuropathy, can occur, particularly in untreated cases.
Observation:
- A 48-year-old male presented with progressive vision loss in his right eye over two months.
- Examination revealed a relative afferent pupillary defect, and visual evoked potential testing showed bilateral P100 latency delay, indicating optic neuropathy.
- Cerebrospinal fluid analysis confirmed lymphocytic meningitis.
Findings:
- The patient was diagnosed with Lyme neuroborreliosis, presenting with meningitis and optic neuritis.
- Treatment with antibiotics led to gradual improvement.
- Follow-up MRI showed residual inflammation and gliosis on the right optic nerve.
Implications:
- Lyme neuroborreliosis should be considered in patients from endemic areas with unexplained neurological and ophthalmological symptoms.
- Prompt diagnosis and treatment are essential to prevent severe complications and long-term sequelae of Lyme disease.
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