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The laboratory diagnosis of ocular Lyme borreliosis.

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Abstract

BACKGROUND:

A study was carried out to evaluate indirect enzyme-linked immunosorbent assay (ELISA), immunoblot analysis, and polymerase chain reaction (PCR) in the diagnostic work-up of ocular
Lyme borreliosis.

METHODS:

Twenty patients with ocular
Lyme borreliosis were examined. IgG and IgM antibodies to Borrelia burgdorferi were measured by ELISA in serum, and in cerebrospinal fluid (CSF) when indicated, and immunoblot analysis of B. burgdorferi IgG antibodies in serum was performed. A nested PCR was used to detect a segment of a gene coding for B. burgdorferi endoflagellin. The samples used in PCR testing were serum and CSF and in isolated cases conjunctiva and vitreous.

RESULTS:

Seventeen patients had elevated Borrelia antibodies in serum or CSF by ELISA. Seven patients, including two with negative ELISA, had a positive immunoblot. Seven of the 13 patients in whom PCR was examined during clinically active
disease had a positive PCR result. Immunoblot analysis gave a negative result from the sera of five PCR-positive patients.

CONCLUSIONS:

For efficient diagnosis of ocular
Lyme borreliosis, immunoblot analysis and PCR should be used in addition to ELISA. A positive PCR seems to be associated with a negative immunoblot.

Graefes Arch Clin Exp Ophthalmol. 1999 Mar;237(3):225-30. Comparative Study; Research Support, Non-U.S. Gov’t

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