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Lyme disease: resolution of a serous retinal detachment and chorioretinal folds after antibiotic therapy.

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Abstract

BACKGROUND:

Ocular manifestations of
Lyme disease are uncommon. There has not been a documented case of serous retinal detachment and chorioretinal folds because of
Lyme disease that have resolved after only antibiotic treatment.

METHODS (CASE REPORT):

A 69-year-old white man with a history of recent tick bites presented with a gradual decrease in visual acuity in the left eye. Initial visual acuity was 3/200 in the left eye. Examination revealed an inferior, serous, macula-off retinal detachment. Chorioretinal folds were also noted.
Lyme screening antibody test (enzyme-linked immunosorbent assay) was positive and a confirmatory Western blot was immunoglobulin M negative and immunoglobulin G positive.

RESULTS:

Oral amoxicillin (500 mg 3 times daily for 2 weeks) was given followed by intravenous ceftriaxone (2 g daily for 4 weeks). After two weeks of ceftriaxone, fundus examination and ultrasonography showed complete reattachment of the macula and periphery, and only mild residual chorioretinal folds remained on fluorescein angiogram.

CONCLUSION:

We suggest that Borrelia burgdorferi infection led to choroidal inflammation with secondary chorioretinal folds and a serous retinal detachment, which resolved with antibiotic therapy alone. This supports the suspicion of an intraocular infection, perhaps involving the choroid, as opposed to a secondary autoimmune reaction.

Retin Cases Brief Rep. 2012 Summer;6(3):232-4. doi: 10.1097/ICB.0b013e3182247783.

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