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James T. Rosenbaum - One of the best experts on this subject based on the ideXlab platform.
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Molecular diagnosis and ocular imaging of varicella zoster virus associated Neuroretinitis.
American journal of ophthalmology case reports, 2018Co-Authors: Rene Y. Choi, Andreas K. Lauer, James T. RosenbaumAbstract:Abstract Purpose To report a case of varicella zoster virus associated Neuroretinitis confirmed via polymerase chain reaction analysis of ocular fluid. Observations A 30-year-old man presented with a 1-week history of decreased vision in his left eye and ulcerative skin lesions above his left eyebrow. On exam, he had clinical findings consistent with Neuroretinitis characterized by optic disc edema and formation of a macular star. Polymerase chain reaction analysis of aqueous fluid was positive for varicella zoster virus. He was treated with oral valacyclovir with excellent resolution of his symptoms and clinical findings. Conclusions and importance Varicella zoster virus is a rare cause of Neuroretinitis. We report for the first time a case of varicella zoster virus associated Neuroretinitis confirmed by polymerase chain reaction analysis of ocular fluid. Molecular testing of ocular tissue may lead to a definitive diagnosis.
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Molecular diagnosis and ocular imaging of varicella zoster virus associated Neuroretinitis.
American journal of ophthalmology case reports, 2018Co-Authors: Rene Y. Choi, Andreas K. Lauer, James T. RosenbaumAbstract:To report a case of varicella zoster virus associated Neuroretinitis confirmed via polymerase chain reaction analysis of ocular fluid. A 30-year-old man presented with a 1-week history of decreased vision in his left eye and ulcerative skin lesions above his left eyebrow. On exam, he had clinical findings consistent with Neuroretinitis characterized by optic disc edema and formation of a macular star. Polymerase chain reaction analysis of aqueous fluid was positive for varicella zoster virus. He was treated with oral valacyclovir with excellent resolution of his symptoms and clinical findings. Varicella zoster virus is a rare cause of Neuroretinitis. We report for the first time a case of varicella zoster virus associated Neuroretinitis confirmed by polymerase chain reaction analysis of ocular fluid. Molecular testing of ocular tissue may lead to a definitive diagnosis.
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Molecular diagnosis and ocular imaging of varicella zoster virus associated Neuroretinitis
Elsevier, 2018Co-Authors: Rene Y. Choi, Andreas Lauer, James T. RosenbaumAbstract:Purpose: To report a case of varicella zoster virus associated Neuroretinitis confirmed via polymerase chain reaction analysis of ocular fluid. Observations: A 30-year-old man presented with a 1-week history of decreased vision in his left eye and ulcerative skin lesions above his left eyebrow. On exam, he had clinical findings consistent with Neuroretinitis characterized by optic disc edema and formation of a macular star. Polymerase chain reaction analysis of aqueous fluid was positive for varicella zoster virus. He was treated with oral valacyclovir with excellent resolution of his symptoms and clinical findings. Conclusions and importance: Varicella zoster virus is a rare cause of Neuroretinitis. We report for the first time a case of varicella zoster virus associated Neuroretinitis confirmed by polymerase chain reaction analysis of ocular fluid. Molecular testing of ocular tissue may lead to a definitive diagnosis. Keywords: Uveitis, Neuroretinitis, Varicella zoster viru
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prevalence of serologic evidence of cat scratch disease in patients with Neuroretinitis
Ophthalmology, 2000Co-Authors: Eric B. Suhler, Andreas K. Lauer, James T. RosenbaumAbstract:Abstract Objective To determine the prevalence of Bartonella henselae seropositivity in patients with a clinical diagnosis of Neuroretinitis. Design Retrospective, clinic-based, cross-sectional study. Participants Eighteen consecutive patients seeking treatment at the Casey Eye Institute from November 1993 through November 1998 who had Neuroretinitis. Methods The billing and photographic records of the Casey Eye Institute were searched for patients with a primary or secondary diagnosis of Neuroretinitis or Leber's idiopathic stellate Neuroretinitis. Charts were then reviewed to determine the results of B. henselae antibody titers and other pertinent clinical information. Main outcome measures Results of B. henselae serologic testing. Results Fourteen of 18 patients with Neuroretinitis had serologic studies. Nine of the 14 tested patients (64.3%) were found to have elevated IgM or IgG for B. henselae , suggesting current or past infection. Patients with positive serologic analysis results tended to have worse vision at presentation. There were no other obvious differences between seropositive and seronegative groups in this study, including duration or quality of recovery. Conclusions At our tertiary care ophthalmology institution, most tested patients with Neuroretinitis had evidence of past or present cat-scratch disease based on positive serologic analysis for B. henselae , a much greater prevalence than is expected to be found in the general population or in patients with idiopathic uveitis. Further study is indicated to clarify the prevalence of cat-scratch disease in Neuroretinitis and the role and efficacy of antibiotics in treatment.
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Prevalence of serologic evidence of cat scratch disease in patients with Neuroretinitis.
Ophthalmology, 2000Co-Authors: Eric B. Suhler, Andreas K. Lauer, James T. RosenbaumAbstract:To determine the prevalence of Bartonella henselae seropositivity in patients with a clinical diagnosis of Neuroretinitis. Retrospective, clinic-based, cross-sectional study. Eighteen consecutive patients seeking treatment at the Casey Eye Institute from November 1993 through November 1998 who had Neuroretinitis. The billing and photographic records of the Casey Eye Institute were searched for patients with a primary or secondary diagnosis of Neuroretinitis or Leber's idiopathic stellate Neuroretinitis. Charts were then reviewed to determine the results of B. henselae antibody titers and other pertinent clinical information. Results of B. henselae serologic testing. Fourteen of 18 patients with Neuroretinitis had serologic studies. Nine of the 14 tested patients (64.3%) were found to have elevated IgM or IgG for B. henselae, suggesting current or past infection. Patients with positive serologic analysis results tended to have worse vision at presentation. There were no other obvious differences between seropositive and seronegative groups in this study, including duration or quality of recovery. At our tertiary care ophthalmology institution, most tested patients with Neuroretinitis had evidence of past or present cat-scratch disease based on positive serologic analysis for B. henselae, a much greater prevalence than is expected to be found in the general population or in patients with idiopathic uveitis. Further study is indicated to clarify the prevalence of cat-scratch disease in Neuroretinitis and the role and efficacy of antibiotics in treatment.
Moncef Khairallah - One of the best experts on this subject based on the ideXlab platform.
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Sequential bilateral Behçet’s Neuroretinitis associated with prepapillary vitreous exudate: case report
2021Co-Authors: Imen Ksiaa, Sourour Zina, Sana Khochtali, Safa Ben Aoun, Dhouha Nefzi, Moncef KhairallahAbstract:Abstract Objective: To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral Neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and Methods: A single case report documented with multimodal imaging.Results: A 37-year-old man developed Neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but one year later a similar Neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. SS OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCTA demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects.Conclusion: Sequential bilateral Neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.
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Is There a True Neuroretinitis in Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN) Syndrome ?
Ocular immunology and inflammation, 2020Co-Authors: Moncef Khairallah, Sana Khochtali, Imen KsiaaAbstract:Purpose : To clarify whether a true Neuroretinitis is part of idiopathic retinal vasculitis, aneurysms, and Neuroretinitis (IRVAN) syndrome.Methods : Critical literature review.Results : Neuroreti...
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Sequential bilateral Behçet's Neuroretinitis associated with prepapillary vitreous exudate: case report
Journal of ophthalmic inflammation and infection, 2020Co-Authors: Imen Ksiaa, Sourour Zina, Sana Khochtali, Safa Ben Aoun, Dhouha Nefzi, Moncef KhairallahAbstract:Objective To describe a case of Behcet disease (BD) uveitis manifesting with sequential bilateral Neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and methods A single case report documented with multimodal imaging. Results A 37-year-old man developed Neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar Neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. Swept source (SS) OCT showed at the acute phase in both eyes a typical "mushroom-shaped" prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects. Conclusion Sequential bilateral Neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.
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Update on Bartonella Neuroretinitis
Journal of current ophthalmology, 2019Co-Authors: Imen Ksiaa, Nesrine Abroug, Anis Mahmoud, Sourour Zina, Alireza Hedayatfar, Sonia Attia, Sana Khochtali, Moncef KhairallahAbstract:To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated Neuroretinitis. This is a narrative review on Bartonella-associated Neuroretinitis including general and ophthalmological aspects of the disease. A comprehensive literature review between January 1950 and September 2018 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of Bartonella Neuroretinitis were reviewed. Cat scratch disease (CSD) is a worldwide distributed systemic infectious disease caused by a bacterium, Bartonella henselae (B. henselae) which is usually transmitted to humans through contact with infected cats. Ocular manifestations of CSD are diverse, with Neuroretinitis and superficial retinal infiltrates being the most common and typical manifestations. Neuroretinitis typically presents as optic disc edema with a partial or complete macular star in association with mild vitritis. Macular star may be absent at the initial presentation, becoming evident 1-2 weeks after the onset of optic disc edema. Diagnosis of CSD is confirmed by reliable laboratory tests. Neuroretinitis usually has a self-limited course. Antibiotic therapy is required for severe systemic disease and vision-threatening ocular involvement. The adjunctive use of oral corticosteroids may further improve the visual outcome. The diagnosis of Bartonella-associated Neuroretinitis is based on typical clinical findings and positive serology. The prognosis is usually favorable in immunocompetent individuals.
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update on bartonella Neuroretinitis
journal of current ophthalmology, 2019Co-Authors: Imen Ksiaa, Nesrine Abroug, Anis Mahmoud, Sourour Zina, Alireza Hedayatfar, Sonia Attia, Sana Khochtali, Moncef KhairallahAbstract:Abstract Purpose To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated Neuroretinitis. Methods This is a narrative review on Bartonella-associated Neuroretinitis including general and ophthalmological aspects of the disease. A comprehensive literature review between January 1950 and September 2018 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of Bartonella Neuroretinitis were reviewed. Results Cat scratch disease (CSD) is a worldwide distributed systemic infectious disease caused by a bacterium, Bartonella henselae (B. henselae) which is usually transmitted to humans through contact with infected cats. Ocular manifestations of CSD are diverse, with Neuroretinitis and superficial retinal infiltrates being the most common and typical manifestations. Neuroretinitis typically presents as optic disc edema with a partial or complete macular star in association with mild vitritis. Macular star may be absent at the initial presentation, becoming evident 1–2 weeks after the onset of optic disc edema. Diagnosis of CSD is confirmed by reliable laboratory tests. Neuroretinitis usually has a self-limited course. Antibiotic therapy is required for severe systemic disease and vision-threatening ocular involvement. The adjunctive use of oral corticosteroids may further improve the visual outcome. Conclusions The diagnosis of Bartonella-associated Neuroretinitis is based on typical clinical findings and positive serology. The prognosis is usually favorable in immunocompetent individuals.
Imen Ksiaa - One of the best experts on this subject based on the ideXlab platform.
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Sequential bilateral Behçet’s Neuroretinitis associated with prepapillary vitreous exudate: case report
2021Co-Authors: Imen Ksiaa, Sourour Zina, Sana Khochtali, Safa Ben Aoun, Dhouha Nefzi, Moncef KhairallahAbstract:Abstract Objective: To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral Neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and Methods: A single case report documented with multimodal imaging.Results: A 37-year-old man developed Neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but one year later a similar Neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. SS OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCTA demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects.Conclusion: Sequential bilateral Neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.
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Is There a True Neuroretinitis in Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN) Syndrome ?
Ocular immunology and inflammation, 2020Co-Authors: Moncef Khairallah, Sana Khochtali, Imen KsiaaAbstract:Purpose : To clarify whether a true Neuroretinitis is part of idiopathic retinal vasculitis, aneurysms, and Neuroretinitis (IRVAN) syndrome.Methods : Critical literature review.Results : Neuroreti...
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Sequential bilateral Behçet's Neuroretinitis associated with prepapillary vitreous exudate: case report
Journal of ophthalmic inflammation and infection, 2020Co-Authors: Imen Ksiaa, Sourour Zina, Sana Khochtali, Safa Ben Aoun, Dhouha Nefzi, Moncef KhairallahAbstract:Objective To describe a case of Behcet disease (BD) uveitis manifesting with sequential bilateral Neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and methods A single case report documented with multimodal imaging. Results A 37-year-old man developed Neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar Neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. Swept source (SS) OCT showed at the acute phase in both eyes a typical "mushroom-shaped" prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects. Conclusion Sequential bilateral Neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.
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Update on Bartonella Neuroretinitis
Journal of current ophthalmology, 2019Co-Authors: Imen Ksiaa, Nesrine Abroug, Anis Mahmoud, Sourour Zina, Alireza Hedayatfar, Sonia Attia, Sana Khochtali, Moncef KhairallahAbstract:To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated Neuroretinitis. This is a narrative review on Bartonella-associated Neuroretinitis including general and ophthalmological aspects of the disease. A comprehensive literature review between January 1950 and September 2018 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of Bartonella Neuroretinitis were reviewed. Cat scratch disease (CSD) is a worldwide distributed systemic infectious disease caused by a bacterium, Bartonella henselae (B. henselae) which is usually transmitted to humans through contact with infected cats. Ocular manifestations of CSD are diverse, with Neuroretinitis and superficial retinal infiltrates being the most common and typical manifestations. Neuroretinitis typically presents as optic disc edema with a partial or complete macular star in association with mild vitritis. Macular star may be absent at the initial presentation, becoming evident 1-2 weeks after the onset of optic disc edema. Diagnosis of CSD is confirmed by reliable laboratory tests. Neuroretinitis usually has a self-limited course. Antibiotic therapy is required for severe systemic disease and vision-threatening ocular involvement. The adjunctive use of oral corticosteroids may further improve the visual outcome. The diagnosis of Bartonella-associated Neuroretinitis is based on typical clinical findings and positive serology. The prognosis is usually favorable in immunocompetent individuals.
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update on bartonella Neuroretinitis
journal of current ophthalmology, 2019Co-Authors: Imen Ksiaa, Nesrine Abroug, Anis Mahmoud, Sourour Zina, Alireza Hedayatfar, Sonia Attia, Sana Khochtali, Moncef KhairallahAbstract:Abstract Purpose To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated Neuroretinitis. Methods This is a narrative review on Bartonella-associated Neuroretinitis including general and ophthalmological aspects of the disease. A comprehensive literature review between January 1950 and September 2018 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of Bartonella Neuroretinitis were reviewed. Results Cat scratch disease (CSD) is a worldwide distributed systemic infectious disease caused by a bacterium, Bartonella henselae (B. henselae) which is usually transmitted to humans through contact with infected cats. Ocular manifestations of CSD are diverse, with Neuroretinitis and superficial retinal infiltrates being the most common and typical manifestations. Neuroretinitis typically presents as optic disc edema with a partial or complete macular star in association with mild vitritis. Macular star may be absent at the initial presentation, becoming evident 1–2 weeks after the onset of optic disc edema. Diagnosis of CSD is confirmed by reliable laboratory tests. Neuroretinitis usually has a self-limited course. Antibiotic therapy is required for severe systemic disease and vision-threatening ocular involvement. The adjunctive use of oral corticosteroids may further improve the visual outcome. Conclusions The diagnosis of Bartonella-associated Neuroretinitis is based on typical clinical findings and positive serology. The prognosis is usually favorable in immunocompetent individuals.
Antonio Marcelo Barbante Casella - One of the best experts on this subject based on the ideXlab platform.
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Clinical treatment of diffuse unilateral subacute Neuroretinitis with albendazole
Arquivos brasileiros de oftalmologia, 2007Co-Authors: Marcus Rudolph Malaguido, Antonio Marcelo Barbante Casella, Daniela Rossetto Garcia MalaguidoAbstract:To describe the evolution of a series of cases of diffuse unilateral subacute Neuroretinitis (DUSN) treated with albendazole. Interventional case series. The authors developed a non-randomized clinical trial protocol to investigate the clinical evolution of diffuse unilateral subacute Neuroretinitis cases treated with albendazole. According to protocol criteria up to now, six patients were selected that will be described separately. Of the six studied patients, four presented the worm. All six patients treated with the antiparasitic drug showed improvement of visual acuity and of chorioretinal scars. During the weeks of treatment, evidence of worm inactivation was documented for the four patients with visible worms. No adverse drug side effects were observed. The antiparasitic drug albendazole seems to be beneficial and safe in patients with diffuse unilateral subacute Neuroretinitis. More studies are necessary to evaluate the effectiveness of albendazole in the treatment of diffuse unilateral subacute Neuroretinitis.
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Antihelminthic drugs in diffuse unilateral subacute Neuroretinitis.
American journal of ophthalmology, 1998Co-Authors: Antonio Marcelo Barbante Casella, Michel Eid Farah, Rubens BelfortAbstract:To evaluate the efficacy of ivermectin and thiabendazole in confirmed cases of diffuse unilateral subacute Neuroretinitis. Two patients with diffuse unilateral subacute Neuroretinitis were treated with anthelminthic drugs. The first patient was treated with ivermectin and the second, with thiabendazole. The worms were still mobile after treatment with ivermectin or thiabendazole. With the application of photocoagulation, the organisms were destroyed, and the patients' vision improved. In these two patients, ivermectin and thiabendazole were not effective in treating confirmed diffuse unilateral subacute Neuroretinitis.
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antihelminthic drugs in diffuse unilateral subacute Neuroretinitis
American Journal of Ophthalmology, 1998Co-Authors: Antonio Marcelo Barbante Casella, Michel Eid Farah, Rubens BelfortAbstract:Purpose: To evaluate the efficacy of ivermectin and thiabendazole in confirmed cases of diffuse unilateral subacute Neuroretinitis. Method: Two patients with diffuse unilateral subacute Neuroretinitis were treated with anthelminthic drugs. The first patient was treated with ivermectin and the second, with thiabendazole. Results: The worms were still mobile after treatment with ivermectin or thiabendazole. With the application of photocoagulation, the organisms were destroyed, and the patients' vision improved. Conclusion: In these two patients, ivermectin and thiabendazole were not effective in treating confirmed diffuse unilateral subacute Neuroretinitis.
Praveen R Murthy - One of the best experts on this subject based on the ideXlab platform.
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Neuroretinitis as a Manifestation of Lyme Disease in South India: A Case Report
Ocular immunology and inflammation, 2010Co-Authors: Kalpana Babu, Praveen R MurthyAbstract:To report a rare case of Lyme disease with Neuroretinitis from South India. Retrospective case report. A 45-year-old lady who hails from the Nagarhole forest in South India presented with a history of tick bite followed by diminution of vision in the left eye. Fundus evaluation of the left eye showed Neuroretinitis. Mantoux test, Treponema pallidum hemagglutination test, serum angiotensin converting enzyme, and ELISA for toxoplasmosis and rickettsial infections were negative. ELISA for Lyme disease was positive for IgM antibodies. This was confirmed by Western blot test. Ocular inflammation resolved with a course of doxycyline and oral steroids. The species of the tick was also identified. This case highlights the need to consider Lyme disease, though rare in India, in the differential diagnosis of Neuroretinitis especially if the patient hails from a forest area.
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Neuroretinitis as a manifestation of lyme disease in south india a case report
Ocular Immunology and Inflammation, 2010Co-Authors: Kalpana Babu, Praveen R MurthyAbstract:Purpose: To report a rare case of Lyme disease with Neuroretinitis from South India.Materials and Methods: Retrospective case report. A 45-year-old lady who hails from the Nagarhole forest in South India presented with a history of tick bite followed by diminution of vision in the left eye. Fundus evaluation of the left eye showed Neuroretinitis. Mantoux test, Treponema pallidum hemagglutination test, serum angiotensin converting enzyme, and ELISA for toxoplasmosis and rickettsial infections were negative. ELISA for Lyme disease was positive for IgM antibodies. This was confirmed by Western blot test.Results: Ocular inflammation resolved with a course of doxycyline and oral steroids. The species of the tick was also identified.Conclusion: This case highlights the need to consider Lyme disease, though rare in India, in the differential diagnosis of Neuroretinitis especially if the patient hails from a forest area.
