engleski

Ocular manifestations of Lyme borreliosis in north-west Croatia

Ocular manifestations of patients with Lyme borreliosis in northwest Croatia that occurred during the period between 1994 – 2001 were retrospectively analysed. The diagnosis of Lyme borreliosis was based on medical history, clinical manifestations, epidemiological data about tick contact, determinations of antibodies to Borrelia burgdorferi by serological assays, immunoblot analysis, therapeutic results and exclusion of other infectious agents of ocular diseases. Of the eleven patients reported here with clinical manifestations of ocular Lyme borreliosis 6 had chorioretinitis, 1 papillitis, 1 iridocyclitis, 1 occlusion of the arteriae centralis retinae, 1 neuritis retrobulbaris and 1 neuroretinitis. Diagnostic confirmation of LB was in most patients done by serological tests and/or by the immunoblot method in serum (and in CSF), but without positive results. In the last few years we have also done culture and molecular diagnostic methods (polymerase chain reaction (PCR)) from serum and from CSF.The patients were treated with 2g of ceftriaxon IV per day for 14-21 days and with doxycyclin orally in a daily doses of 2x100mg for 3 weeks. The therapeutic effect was followed up by regression of clinical symptoms and in changing of the specific antibody titar in serological tests. The authors emphasise the more detailed diagnostic proceedings of ocular Lyme borreliosis in patients suspect on Lyme borreliosis (positive contact with ticks and/or the history of erythema migrans). It is necessary to use enzyme-immuno assay and immunoblot methods in serum, cerebrospinal fluid and humor acueous, and also molecular methods (PCR) of the same diagnostic samples. Ocular Lyme borreliosis is an underdiagnosed disorder, becouse unrecognised disease by ophtalmologists and weak sropositivity and seronegativity in the late ocular Lyme disease. It is especially important in a high endemic area for Lyme borreliosis like north-west Croatia, a border area of the central European endemic area for Lyme borreliosis.

Lyme borreliosis; ocular manifestations; north-west Croatia

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