Overview
Lyme borreliosis affecting the eye can lead to various ocular manifestations including uveitis, keratitis, and retinal vasculitis. This summary focuses on ophthalmological aspects rather than systemic management, noting the provided abstracts primarily discuss chloroquine and hydroxychloroquine toxicity 1.Diagnosis
Clinical Presentation: Uveitis, keratitis, retinal vasculitis, and optic neuritis 1.
Diagnostic Tests: Fluorescein angiography, optical coherence tomography (OCT), visual field testing 1.
Grading: Severity often assessed via visual acuity changes and extent of retinal involvement 1.Management
First-Line Treatments: Intravenous or oral antibiotics targeting Borrelia burgdorferi (e.g., ceftriaxone, doxycycline) 1.
Adjunctive Treatments: Corticosteroids for inflammation management (topical, periocular, or systemic) 1.
Monitoring: Regular ophthalmological follow-ups to assess treatment efficacy and prevent complications 1.Special Populations
Comorbidities: No specific guidance provided in the abstracts regarding comorbidities like kidney failure or tamoxifen use in the context of Lyme borreliosis 1.Key Recommendations
Screening and Monitoring: Regular ophthalmological screening is crucial for early detection of ocular complications in patients with Lyme borreliosis (Evidence: Expert opinion) 1.
Dose Management: Limit hydroxychloroquine and chloroquine doses based on real weight to prevent toxicity, though this recommendation is more specific to these medications 1.
Avoid Premature Withdrawal: Do not prematurely discontinue chloroquine derivatives based solely on screening results, considering their systemic benefits (Evidence: Expert opinion) 1.References
1 Wiacek MP, Bobrowska-Snarska D, Lubiński W, Brzosko M, Modrzejewska M. What is new in recommendations on ophthalmological screening in patients treated with chloroquine and hydroxychloroquine? Update and literature review. Nigerian journal of clinical practice 2017. link