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Uveitis and Lyme borreliosis
J Breeveld1, H Kuiper, L Spanjaard
1Department of Ophthalmology, Academic Medical Centre, Amsterdam, The Netherlands.
The British Journal of Ophthalmology
|August 1, 1993
Summary
Serological tests for Lyme borreliosis were positive in 14% of uveitis patients with unknown origin and 5% with known cause. However, none met CDC criteria for Lyme disease diagnosis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Uveitis, inflammation of the uvea, can have diverse etiologies.
- Lyme borreliosis is a tick-borne illness that can manifest with ocular symptoms, including uveitis.
- Accurate diagnosis of Lyme borreliosis in uveitis patients is crucial for appropriate treatment.
Purpose of the Study:
- To investigate the seroprevalence of Lyme borreliosis in patients presenting with uveitis.
- To correlate serological findings with clinical manifestations in uveitis patients.
- To assess the utility of serological testing for Borrelia burgdorferi in diagnosing Lyme borreliosis-associated uveitis.
Main Methods:
- Retrospective analysis of 112 consecutive uveitis patients (56 unknown origin, 56 established etiology).
- Serological testing for Borrelia burgdorferi antibodies using indirect immunofluorescence assay (IFA) and enzyme-linked immunosorbent assay (ELISA).
- Clinical evaluation to determine if patients met Centers for Disease Control and Prevention (CDC) criteria for Lyme borreliosis.
Main Results:
- Positive serological tests for Borrelia burgdorferi were observed in 14% (8/56) of patients with uveitis of unknown origin.
- A lower rate of positive serology (5%, 3/56) was found in patients with uveitis of established etiology.
- None of the investigated patients fulfilled the CDC diagnostic criteria for Lyme borreliosis, despite positive serological results.
Conclusions:
- Serological evidence of Borrelia burgdorferi infection is present in a notable proportion of uveitis patients, particularly those with idiopathic uveitis.
- Positive serological tests alone may not be sufficient for diagnosing Lyme borreliosis-related uveitis, as clinical criteria were not met.
- Further research is warranted to understand the clinical significance of positive Lyme serology in the absence of classic Lyme disease symptoms in uveitis patients.