Ocular manifestations in children and adolescents with Lyme arthritis

BACKGROUND Lyme arthritis is the most frequent late manifestation of Lyme borreliosis and has been associated with ocular inflammation. METHODS A group of 153 children and adolescents with arthritis, 84 of whom had Lyme arthritis and 69 other causes of arthritis, were followed prospectively for 22–7...

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Bibliographic Details
Published in:British journal of ophthalmology 1999-10, Vol.83 (10), p.1149-1152
Main Authors: Huppertz, Hans-Iko, Münchmeier, Doris, Lieb, Wolfgang
Format: Article
Language:English
Subjects:
Adolescent
anterior uveitis
Arthritis, Infectious - complications
Biological and medical sciences
Child
Child, Preschool
Diseases of the osteoarticular system
Eye Infections, Bacterial - complications
Eye Infections, Bacterial - physiopathology
Female
Follow-Up Studies
Humans
Inflammatory joint diseases
intermediate uveitis
keratitis
Keratitis - microbiology
Lyme arthritis
Lyme Disease - complications
Lyme Disease - physiopathology
Male
Medical sciences
Original articles - Clinical science
Prospective Studies
Uveitis, Anterior - microbiology
Uveitis, Intermediate - microbiology
Visual Acuity
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Summary:BACKGROUND Lyme arthritis is the most frequent late manifestation of Lyme borreliosis and has been associated with ocular inflammation. METHODS A group of 153 children and adolescents with arthritis, 84 of whom had Lyme arthritis and 69 other causes of arthritis, were followed prospectively for 22–73 (median 44) months in the course of a national study. RESULTS Three of 84 patients with Lyme arthritis had ocular inflammation (4%), including keratitis, anterior uveitis, and uveitis intermedia. All three had symptoms of decreased visual acuity. Whereas anterior uveitis disappeared without sequelae, a corneal scar and a permanent loss of visual acuity in the patients with keratitis and intermediate uveitis remained. Systematic examination of all patients revealed no further ocular involvement. Of 69 patients with other causes of arthritis who were followed in parallel as a control group, four of 15 patients with early onset pauciarticular juvenile rheumatoid arthritis had chronic anterior uveitis and two of 12 patients with juvenile spondyloarthropathy had acute anterior uveitis. CONCLUSIONS Ocular involvement with keratitis, anterior uveitis, and intermediate uveitis may occur in children and adolescents with Lyme arthritis. Visual loss appears to be symptomatic, making regular ocular screening of such patients unnecessary.
ISSN:0007-1161
1468-2079
DOI:10.1136/bjo.83.10.1149