Is it?
I saw a neuro-opthamologist last year when I was having an episode, she told me that in her opinion it was related.
[This message has been edited by hwlatin (edited 17 February 2005).]
[Unusual case of bilateral optic neuritis in Lyme neuroborreliosis]
[Article in French]
Bouat C, Meyer F, Rosier S, Boitte JP, Lawani R, Bregigeon M.
Service d'Ophtalmologie, l'Hopital d'Instruction des Armees Laveran, Marseille, France.
The most common manifestations of Lyme disease are neurologic and rheumatologic, but ophthalmologic lesions can also occur and may even be dominant. The authors describe a case of bilateral optic neuropathy associated with Lyme borreliosis that quickly led to near-total blindness. In addition to a loss in visual acuity and field bilateral papillary edema was documented by angiofluorography. A spectacular improvement was obtained under combined antimicrobial therapy using doxycycline and corticosteroid therapy. The patient rapidly recovered full vision. These observations are discussed within the context of Lyme disease with a review of other relevant ophthalmologic complications. The importance of careful interpretation of serology is emphasized.
Publication Types:
* Case Reports
PMID: 10906986 [PubMed - indexed for MEDLINE]
Optic Neuritis Due to Bartonella henselae Infection
A 14-year-old girl presented with worsening headaches, unilateral decreased visual acuity (20/20 in the right eye and 5/200 in the left eye), and ocular pain in the left eye. The results of a neurologic examination were unremarkable. Contrast-enhanced computed tomography of the head and a lumbar puncture showed no abnormalities. A retinal examination showed bilateral optic-disk elevation with edema, lipid exudates that formed a macular star, and an area of choroiditis surrounded by serous fluid. The results of serologic evaluation for syphilis and Lyme disease and of a skin test for tuberculosis were negative. Indirect immunofluorescence assays showed that the titers of antibodies against Bartonella henselae were 1:160 or more for IgM and 1:512 or more for IgG. This constellation of findings has been called Leber's idiopathic stellate neuroretinitis, according to a description by Theodor Leber in 1916. Modern serodiagnostic testing has shown that in many cases the findings are due to B. henselae, the gram-negative bacterium that causes cat scratch disease. The patient owned a cat but did not recall a specific scratch.
Pharmacologic treatment of optic neuritis due to B. henselae infection in immunocompetent hosts is of uncertain value; the symptoms can resolve spontaneously, and controlled studies are lacking. Nonetheless, our patient was treated with prednisone and azithromycin. Six months later, the lipid exudates in the macula had been reabsorbed, and normal vision (20/20 in the right eye and 20/25 in the left eye) had returned.
[Ophthalmic manifestations in Lyme borreliosis]
[Article in Polish]
Zagorski Z, Biziorek B, Haszcz D.
Katedra i I Klinika Okulistyki Akademii Medycznej w Lublinie.
We reviewed ophthalmic manifestations in Lyme borreliosis, concentrating on clinical and laboratory diagnosis, differential diagnosis and treatment options. Ocular involvement may occur in every stage of the disease. Conjunctivitis and episcleritis are the most frequent manifestations of the early stage. Neuro-ophthalmic disorders and uveitis occur in the second stage whereas keratitis, chronic intraocular inflammation and orbital myositis have been reported in the third stage of borreliosis.
Publication Types:
* Review
* Review, Tutorial
PMID: 12194235 [PubMed - indexed for MEDLINE]
1: J Fr Ophtalmol. 2004 Mar;27(3):285-90
[Cat-scratch disease neuroretinitis]
[Article in French]
Donnio A, Buestel C, Ventura E, Merle H.
Service d'Ophtalmologie, CHU, Hopital Pierre Zobda-Quitman, BP 632, 97261 Fort de France. [email protected]
We report a case of cat-scratch disease neuroretinitis for which systemic and ocular investigations proved the responsibility of Bartonella henselae. An 11-year-old boy was referred to the hospital in November 2002 for severe visual loss in the left eye over the preceding 2 weeks. At the same time, he also developed a flu-like illness. The best corrected acuity in the left eye was counting fingers at 30 cm. Posterior segment examination on the left eye showed an optic disk edema with papillary and peripapillary hemorrhages and serous retinal detachment, mild vitreous inflammation, and two little perivascular white spots. The medical history was unremarkable except for a cat scratch on his left forearm 2 months before. Four weeks of antibiotic therapy including oral rifampin and doxycycline was used. Bartonella henselae immunoglobulin M were first detected with Bartonella henselae immunoglobulin G testing negative at this time. A 3-week serum showed immunoglobulin M seroreversion, while Bartonella henselae immunoglobulin G appeared. Other causes of optic disk edema with macular star were excluded by biological data. Bartonella antibodies to both Bartonella henselae and Bartonella clarridgeiae were detected in the cat. Ophthalmic follow-up showed progressive resorption of the neuroretinitis and the visual acuity increased to 5/10. The significance of this case report lies in the reminder that this pathology can be the cause of neuroretinitis; the prognosis can be improved by earlier treatment.
PMID: 15039632 [PubMed - in process]
We went there to see him and I was truly impressed. Please email if you'd like the info! [email protected]
Sherry
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Optic neuritis is also a possible symptom of early onset MS...Lyme and MS are most likely the same thing. I had a 'probable MS' diagnosis before I saw a LLMD.
I am not sure but maybe Bartonella can cause eye involvement & I have this too.
Opthamologists are not trained in diagnosing Lyme eye problems much like the majority of the medical profession.
They often do say that MS patients get eye blurring in hot water (I used to before antibiotics)...which makes sense as we know how spirochetes hate the heat.
Emma
Quest
[This message has been edited by suki444 (edited 18 February 2005).]