Table 1 The reported cases of Lyme Optic neuritis
Cases | Age/Sex | Tick Bite | Erythema Migrans | Signs and Symptoms | Fundus | Imaging/Testing | Treatment | Treatment outcome |
|---|---|---|---|---|---|---|---|---|
Cruz, et al. (2020) [18] | 48/M | Does not recall | Unreported | 1. Blurry vision OD 2. Inferior visual field defect 3. RAPD OD 4. Photopsia | 1. Pale optic disc 2. Edema of inferior quadrant OD 3. Hyperemia and diffuse edema OS | MRI: unremarkable VEP: delayed bilaterally VF: generalized deficit on the right eye and a left inferior scotoma | Ceftriaxone | Improved, lost to follow up due to patient relocation |
Jha, et al. (2018) [19] | 46/F | Does not recall | Unreported | 1. Progressive blurry vision > 3 wks. 2. Upper respiratory symptoms 3. Paresthesia 4. Nausea 5. Weakness 6. Bilateral lower extremities paresthesia | 1. Bilateral optic head edema 2. Hyperemia 3. Optic disc edema | MRI: nonspecific white matter hyperintensities VF: Cecocentral defects OU | Doxycycline | Patient did not return for follow up |
Wang, et al.(2017) [20] | 50/F | Does not recall | Pruritic rash on neck, chest, and right lower extremities | 1. Right sided headache 2. Unspecified eye pain 3. Blurry vision OD | 1. Optic head edema OD | MRI: enhancement of right optic nerve | Ceftriaxone Methylprednisolone | Improved in symptoms MRI shows resolution of findings |
Burakgazi and Henderson (2016) [21] | 59/F | Does not recall | Shoulders extending to midback, part of chest, left shoulder and right cheek | 1. Blurry vision OD for 3–4 wks. 2. Fatigue and generalized joint pain | 1. Optic head edema OD | MRI: unremarkable VF: unspecified visual field defect VA: 20/30 OD, 20/20 OS | Doxycycline | Improved visual deficits and symptoms |
Tzoukeva, et al. (2014) [22] | 42/F | Does not recall | Absence | 1. Progressive blurry vision OS 2. Painful ocular movement 3. Left RAPD 4. Decreased color vision | Unremarkable | MRI: typical lesion characteristics of MS | Methylprednisolone Medaxone Cefprozil | Normalized |
Qureshi, et al. (2016) [23] | 43/M | Does not recall | unreported | 1. Headache 2. Paresthesia 3. Nuchal rigidity 4. Kernig and Brudzinski sign 5. Seizure episodes | 1. Posterior uveitis 2. Bilateral papillitis | MRI: diffuse hyperintensities involving supra and infratemporal cortical sulci consistent with diffuse leptomeningoencephalitis | Doxycycline Ketorolac | Normalized |
McVeigh and Vakros (2012) [24] | 48/M | Denies recent bites, but had sustained bites previously | Absence | 1. Bilateral loss of visual acuity 2. Painful ocular movements 3. Photophobia 4. Visual distortion 5. Ataxia 6. Headache | 1. Uveitis 2. Bilateral disc swelling 3. Splinter hemorrhage OD | Unspecified | Oral Steroid Ceftriaxone Doxycycline Amoxicillin | Normalized (Mild pallor of the left disc) |
Blanc, et al.(2010) [25] | 63/F | Yes | Unreported | 1. Blurry vision OD 2. Headache 3. Arthralgia | Unspecified | MRI: 3 nonspecific lesions on T2 FLAIR and T2 weighted VEP: delayed bilaterally VA: 20/200 OD | Ceftriaxone | Visual acuity improved to 20/80 |
Blanc, et al.(2010) [25] | 48/F | Yes | Denies | 1. Arthralgia 2. Headache 3. Blurry vision | 1. Bilateral papillitis | MRI: 2 nonspecific subcortical Flair lesions in left frontal lobe (< 3 mm in diameter) VA: 20/100 OS | Ceftriaxone Methylprednisolone | Visual acuity improved to 20/20 |
Santino, et al. (2009) [26] | 33/M | Unspecified | Unspecified | 1. Right central scotoma 2. Blurry vision | 1. Bilateral papillitis | VA: 4/10 OD 10/10 OS | Methylprednisolone Ceftriaxone | Visual acuity improved to 10/10 OU |
Krim, et al. (2007) [27] | 67/M | Yes | Right arm | 1. Fatigue 2. Myalgia 3. Neck radiculopathy 4. Facial weakness 5. Ptosis 6. Diplopia 7. Fever 8. Peripheral right facial palsy 9. Right arm paresis 10. Retrobulbar pain 11. Diminished color perception OD | 1. Bilateral uveitis | MRI: unremarkable VEP: delayed OD VF: central scotoma OD VA: 5/10 OD 8/10 OS | Ceftriaxone Corticotherapy | Neurological symptoms resolved, and visual acuity improved to 10/10 OU |