Retinitis in Lyme Disease Definition

Inflammation of the retina usually caused by Borrelia burgdorferi.

Epidemiology: The incidence of this retinal disorder has increased in recent years.

Etiology: The inflammation is caused by spirochetes usually transmitted by bites from infected ticks.

Findings and symptoms: Lyme disease can lead to many inflammatory ocular changes with their respective symptoms. These include conjunctivitis, keratitis, and iridocyclitis. Retinal vasculitis, retinal artery occlusion, neu-roretinitis, optic neuritis, and choroiditis have also been described.

Lyme disease should be excluded as a possible cause of posterior uveitis of uncertain etiology.

Diagnostic considerations: The diagnosis is made by ophthalmoscopy and serologic studies to identify the pathogen.

Differential diagnosis: Inflammatory ocular changes due to other causes (such as toxoplasmosis or tuberculosis) should be excluded.

Treatment: Antibiotic treatment with tetracycline, penicillin G, or third-generation cephalosporins is indicated.

Clinical course and prognosis: Retinal changes due to Lyme disease tend to recur.

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