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BRIEF COMMUNICATION
Year : 2017  |  Volume : 65  |  Issue : 3  |  Page : 250-252

Neuroretinitis as presenting and the only presentation of Lyme disease: Diagnosis and management


1 Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
2 Department of Ophthalmology, Sanjay Gandhi Memorial Hospital, New Delhi, India

Correspondence Address:
Brahm Prakash Guliani
Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_151_17

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We present a case of neuroretinitis as presenting and the only presentation of Lyme disease in a 25-year-old female who visited hilly areas in the Himalayas of North India. She presented with right eye sudden and painless blurring of vision. Her vision at presentation was 20/60. She had fundus examination; fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) imaging showed classical features of neuroretinitis. No other organ was involved. Oral steroids were prescribed and relevant investigations sent for noninfective and infective causes. Worsened visual acuity (VA) to hand movement and positive IgM titers for Borrelia burgdorferi led to the diagnosis of Lyme disease-associated neuroretinitis. Treatment with oral doxycycline plus oral steroids for 4 weeks revealed VA of 20/20 and resolution of fundus and OCT changes. Neuroretinitis as presenting and the only presentation of Lyme disease will be discussed with serial fundus, FFA, and OCT pictures.


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