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Borrelia Ocular Infection: A Case Report and a Systematic Review of Published Cases
Department of Ophthalmology, Falu Hospital, Falun, Sweden; Center for Clinical Research, Dalarna, Uppsala University, Uppsala, Sweden.
Örebro University, School of Medical Sciences. Center for Clinical Research, Dalarna, Uppsala University, Uppsala, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Ophthalmology, St Erik's Eye Hospital, Stockholm, Sweden.
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2022 (English)In: Ophthalmic Research, ISSN 0030-3747, E-ISSN 1423-0259, Vol. 65, no 2, p. 121-130Article, review/survey (Refereed) Published
Abstract [en]

INTRODUCTION: Lyme borreliosis can cause many diverse manifestations, also ocular disease where the diagnosis of ocular borreliosis is challenging. The primary aim was to report on the evidence of Borrelia spirochetes in the ocular tissue in presumed ocular borreliosis.

METHODS: A systematic review of pathological eye conditions was performed where Borrelia has been suspected in relevant ocular tissue, together with a case report of diagnosed uveitis with polymerase chain reaction (PCR)-confirmed Borrelia afzelii in the vitreous. The evidence for clinical and laboratory diagnosis was evaluated systematically. As a secondary aim, the treatment of ocular Borrelia infection was also evaluated for confirmed cases.

RESULTS: Thirteen includable studies were found, and after the removal of case duplicates, eleven unique cases were extracted. Apart from the present case report, 4 other cases reported strong evidence for the detection of B. spirochetes in ocular tissue. Four cases presented reasonable evidence for assumed detected Borrelia, while three additional cases showed only weak diagnostic credibility that Borrelia was detected.

CONCLUSION: This systematic review, including all reported cases and our case report, supports evidence of ocular infection of Borrelia species. Furthermore, in case of suspicion of infection and seronegativity, it is justified to look for Borrelia in eye tissue samples. In addition, microscopy without using PCR is not sufficient to confirm the diagnosis of borreliosis on ocular tissue. In the articles studied, there was no unambiguous recommendation of treatment.

Place, publisher, year, edition, pages
S. Karger, 2022. Vol. 65, no 2, p. 121-130
Keywords [en]
Borrelia spirochetes, Inflammation/uveitis, Microscopy, Ocular tissue, Polymerase chain reaction
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-96489DOI: 10.1159/000521307ISI: 000796398000001PubMedID: 35034015Scopus ID: 2-s2.0-85128948903OAI: oai:DiVA.org:oru-96489DiVA, id: diva2:1628969
Funder
Uppsala University
Note

Funding agency:

Centre for Clinical Research Dalarna CKFUU-935990 CKFUU-939634

Available from: 2022-01-17 Created: 2022-01-17 Last updated: 2022-05-31Bibliographically approved

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Skogman, Barbro Hedin

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