Visual loss associated with rickettsial disease

Ocul Immunol Inflamm. 2014 Oct;22(5):373-8. doi: 10.3109/09273948.2013.848907. Epub 2013 Oct 30.

Abstract

Abstract Purpose: To characterize and analyze ocular involvement associated with visual loss in a cohort of patients with rickettsial disease.

Methods: Retrospective study of 16 eyes of 14 patients.

Results: Mean initial visual acuity (VA) was 20/63 (range, 20/800-20/25). White retinal lesions infiltrating inner retina was the most common finding occurring in 14 eyes (87.5%). It was associated with a serous retinal detachment (SRD), accurately detectable by optical coherence tomography, in 11 eyes (78.6%). Other findings included optic neuropathy in 7 eyes (43.75%), cystoid macular edema in 1 eye (6.25%), branch retinal artery occlusion in 1 eye (6.25%), and choroidal neovascularization in 1 eye (6.25%). Thirteen patients were treated with a 2-week course of oral doxycycline 200 mg/day. Mean final VA was 20/40.

Conclusions: Inner retinitis, associated with mild vitritis and SRD, and optic neuropathy are the most common vision-threatening ocular manifestations of rickettsial disease.

Keywords: Optic neuropathy; retinitis; rickettsioses; serous retinal detachment; visual loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Bacterial / analysis
  • Blindness / diagnosis
  • Blindness / etiology*
  • Blindness / physiopathology
  • Diagnosis, Differential
  • Eye Infections, Bacterial / complications*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / microbiology
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rickettsia / immunology*
  • Rickettsia Infections / complications*
  • Rickettsia Infections / diagnosis
  • Rickettsia Infections / microbiology
  • Tomography, Optical Coherence
  • Visual Acuity*
  • Young Adult

Substances

  • Antibodies, Bacterial