A clinical case of bilateral chorioretinitis with serologically positive borreliosis complicated by cystoid macular edema
Purpose
To demonstrate a case of bilateral chorioretinitis on the background of borreliosis.
Methods
We propose to consider this clinical case from our practice for a better understanding of the course and control of borrelial chorioretinitis.
Results
Patient K., 39 years old, military. In June 2022, complaints of eye redness, bad visus, distortion of lines, weakness, an increase in body temperature up to 37.5 and headache. Visus OU 0,8, pressure OU 14/15. Both eyes: injection, on the fundus diffuse chorioretinal foci, vasculitis, macular edema. To establish etiology: ANA, ANCA, antibodies to Trep.Pallidum - negative, HIV 1/2 - not detected. Taking into account the patient's activity, a serological test was performed for the antibody to Borrelia Burgdorferi. IgM blot is positive. Treatment: Ceftriaxone 1.0 2 times a day – 3 weeks. A month later pigment appeared on the chorioretinal foci, Visus OU 1.0, pressure OU 15/15. Macular edema persisted. Methylprednisolone 32 mg/day was added on a tapering schedule. No positive effect. Based on world literature about the regression of macular edema against the background of instillations of carbonic anhydrase inhibitors, added to treatment. On follow-up after 6 weeks visus OU 1.0, pressure OU 16/14. He has no complaints. On OCT the macular edema of OU is almost completely regressed, gentle ERM, choroidal foci with pigment deposition.
Conclusion
This case is another illustration of the pathology of the eye against the background of serologically confirmed Borrelia Burgdorferi. The use of carbonic anhydrase inhibitor instillations to control secondary macular edema against the background of regression of the inflammatory process can be used.
Conflict of interest
No
Authors 1
Last name
ZBOROVSKA
Initials of first name(s)
O
Department
The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS/Uveitis department
City
Odesa
Country
Ukraine
Authors 2
Last name
Kolesnichenko
Initials of first name(s)
V
Department
The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS/Uveitis department
City
Odesa
Country
Ukraine
Authors 3
Last name
Dorokhova
Initials of first name(s)
O
Department
The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS/Uveitis department
City
Odesa
Country
Ukraine
Authors 4
Last name
Horianova
Initials of first name(s)
I
Department
The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS/Uveitis department
City
Odesa
Country
Ukraine
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