Peripapillary ischemia as a potential screening biomarker for early detection of tick-borne infection

The objective of this study was to determine whether an observed peripapillary ischemia is a potential biomarker of tick-borne infection (TI).

An experimental design analyzing the optic nerve to demonstrate peripapillary ischemia and vessel density changes through ocular coherence tomography with angiography in subjects with TI. Glaucoma was ruled out and the study engaged subjects in the age range 8-40 years. All subjects in the experimental group experienced visual symptoms. Subjects in the control group were asymptomatic and not previously diagnosed with TI. The ocular coherence tomography with angiography scanned the vessel density of the pericapillary plexus surrounding the optic nerves; the images were rated by percentage of vessel density. A two-tail t-test analysis was used to analyze the results.

The t-test for each measure comparing the difference-of-differences to a zero change at baseline returned statistically significant, demonstrating reduced vessel density for the subjects in the experimental group (P <0.0001; 95% confidence interval [32.37409-43.50091]).

The appearance of peripapillary ischemia in persons below the age of 50 years represents a potential screening biomarker of TI. Primary care physicians, ophthalmologists, and optometrists who have patients presenting sudden onset of visual symptoms in addition to the appearance of peripapillary ischemia should be tested to rule out a TI.