Document Detail

Optic nerve involvement in Lyme disease.
MedLine Citation:
PMID:  23047166     Owner:  NLM     Status:  In-Data-Review    
PURPOSE OF REVIEW: The tick-borne spirochete Borrelia burgdorferi sensu lato can cause several neural manifestations from the peripheral and central neural system. There are several case reports in the literature of optic nerve involvement in association with Lyme neuroborreliosis, but clinical guidelines as to when Lyme disease should be considered in optic neuropathy is lacking.
RECENT FINDINGS: Papilledema caused by raised intracranial pressure in Lyme meningitis seems mainly to affect children, although some adult cases have been reported. Very few cases of retrobulbar optic neuritis, papillitis, neuroretinitis and ischemic optic neuropathy have shown evidence of a strong association with Lyme neuroborreliosis.
SUMMARY: Optic neuropathy in Lyme neuroborreliosis is rare. The cases reported in the literature are not sufficient for making a list of clinical 'red flags'. However, in adult cases, special attention seems reasonable in patients with painless visual loss, bilateral optic nerve head swelling with or without an elevated cerebrospinal fluid opening pressure. In endemic areas, any optic neuropathy may still be considered for a Lyme neuroborreliosis work-up. The use of accepted criteria for establishing the diagnosis of Lyme neuroborreliosis is emphasised.
Frank Träisk; Lars Lindquist
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in ophthalmology     Volume:  23     ISSN:  1531-7021     ISO Abbreviation:  Curr Opin Ophthalmol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011108     Medline TA:  Curr Opin Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  485-90     Citation Subset:  IM    
aDepartment of Clinical Neuroscience and Clinic of Neuro-Ophthalmology, Karolinska Institute, St Erik Eye Hospital, Stockholm bDepartment of Medicine and Clinic for Infectious Diseases, Karolinska Institute, Karolinska University Hospital, Huddinge, Sweden.
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