Tags

Type your tag names separated by a space and hit enter

Ophthalmological findings in neuroborreliosis - a prospective study performed in western Sweden.
Acta Ophthalmol. 2019 Feb; 97(1):44-52.AO

Abstract

PURPOSE

To evaluate and follow-up ophthalmological findings in individuals diagnosed with neuroborreliosis, confirmed by cerebrospinal fluid (CSF) analysis.

METHODS

Twenty-four individuals (13 males), mean age 43.5 ± 18.2 years, with strong clinical suspicion of neuroborreliosis, were referred to the Department of Ophthalmology by the Department of Infectious Diseases at Sahlgrenska University Hospital, Gothenburg, Sweden. All subjects underwent serological and CSF analysis. A structured history taking and a detailed ophthalmological examination were performed prospectively.

RESULTS

Diagnosis for neuroborreliosis was confirmed as definite in 16, possible in two and negative in four individuals, while two had unknown diagnosis. The majority (n = 14/18) with definite and possible diagnoses had ophthalmological symptoms and/or findings either in history or at examination. The most common findings were visual disturbance, diplopia, red eyes, photophobia, facial palsy with palpebral diastasis, strabismus and sixth nerve palsy. The number of symptoms and findings was correlated with immunoglobulin G (IgG)/IgM in CSF (r = 0.6, p = 0.009/0.016; Spearman's correlation). All subjects improved, except one with initially fulminant papilloedema, who still suffered from optic disc atrophy and affected visual fields at the last follow-up.

CONCLUSION

The majority of patients diagnosed with neuroborreliosis had ophthalmological symptoms and/or findings. Facial palsy with palpebral diastasis was a common finding. Onset of diplopia and/or sixth nerve affection may be a first sign of neuroborreliosis. Number of ophthalmological findings was correlated with the CSF antibody titre. Ticks are becoming more widespread and abundant, resulting in a higher incidence of neuroborreliosis. Hence, the knowledge of ophthalmological symptoms and findings is of great importance.

Authors+Show Affiliations

Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.Department of Communicable Disease Control, Region Västra Götaland, Gothenburg, Sweden. Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30146785

Citation

Škiljić, Dragana, et al. "Ophthalmological Findings in Neuroborreliosis - a Prospective Study Performed in Western Sweden." Acta Ophthalmologica, vol. 97, no. 1, 2019, pp. 44-52.
Škiljić D, Gustavsson M, Dotevall L, et al. Ophthalmological findings in neuroborreliosis - a prospective study performed in western Sweden. Acta Ophthalmol. 2019;97(1):44-52.
Škiljić, D., Gustavsson, M., Dotevall, L., Norrsell, K., & Grönlund, M. A. (2019). Ophthalmological findings in neuroborreliosis - a prospective study performed in western Sweden. Acta Ophthalmologica, 97(1), 44-52. https://doi.org/10.1111/aos.13884
Škiljić D, et al. Ophthalmological Findings in Neuroborreliosis - a Prospective Study Performed in Western Sweden. Acta Ophthalmol. 2019;97(1):44-52. PubMed PMID: 30146785.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ophthalmological findings in neuroborreliosis - a prospective study performed in western Sweden. AU - Škiljić,Dragana, AU - Gustavsson,Martin, AU - Dotevall,Leif, AU - Norrsell,Kerstin, AU - Grönlund,Marita Andersson, Y1 - 2018/08/26/ PY - 2018/02/09/received PY - 2018/07/02/accepted PY - 2018/8/28/pubmed PY - 2019/2/20/medline PY - 2018/8/28/entrez KW - Borrelia burgdorferi KW - Lyme disease KW - borreliosis KW - diplopia KW - facial palsy KW - sixth nerve palsy KW - tick SP - 44 EP - 52 JF - Acta ophthalmologica JO - Acta Ophthalmol VL - 97 IS - 1 N2 - PURPOSE: To evaluate and follow-up ophthalmological findings in individuals diagnosed with neuroborreliosis, confirmed by cerebrospinal fluid (CSF) analysis. METHODS: Twenty-four individuals (13 males), mean age 43.5 ± 18.2 years, with strong clinical suspicion of neuroborreliosis, were referred to the Department of Ophthalmology by the Department of Infectious Diseases at Sahlgrenska University Hospital, Gothenburg, Sweden. All subjects underwent serological and CSF analysis. A structured history taking and a detailed ophthalmological examination were performed prospectively. RESULTS: Diagnosis for neuroborreliosis was confirmed as definite in 16, possible in two and negative in four individuals, while two had unknown diagnosis. The majority (n = 14/18) with definite and possible diagnoses had ophthalmological symptoms and/or findings either in history or at examination. The most common findings were visual disturbance, diplopia, red eyes, photophobia, facial palsy with palpebral diastasis, strabismus and sixth nerve palsy. The number of symptoms and findings was correlated with immunoglobulin G (IgG)/IgM in CSF (r = 0.6, p = 0.009/0.016; Spearman's correlation). All subjects improved, except one with initially fulminant papilloedema, who still suffered from optic disc atrophy and affected visual fields at the last follow-up. CONCLUSION: The majority of patients diagnosed with neuroborreliosis had ophthalmological symptoms and/or findings. Facial palsy with palpebral diastasis was a common finding. Onset of diplopia and/or sixth nerve affection may be a first sign of neuroborreliosis. Number of ophthalmological findings was correlated with the CSF antibody titre. Ticks are becoming more widespread and abundant, resulting in a higher incidence of neuroborreliosis. Hence, the knowledge of ophthalmological symptoms and findings is of great importance. SN - 1755-3768 UR - https://www.unboundmedicine.com/medline/citation/30146785/Ophthalmological_findings_in_neuroborreliosis___a_prospective_study_performed_in_western_Sweden_ L2 - https://doi.org/10.1111/aos.13884 DB - PRIME DP - Unbound Medicine ER -