Reactive Lyme serology in optic neuritis

Patrick Sibony, John Halperin, P. K. Coyle, Kartik Patel

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Background: Establishing a causal relationship between optic neuritis and Lyme disease (LD) has been hampered by technical limitations in serologic diagnosis of LD. Even so, there is a general impression that optic neuritis is a common manifestation of LD. Methods: Retrospective case analysis of Lyme serology in 440 patients with optic neuritis examined between 1993 and 2003 in a single neuro-ophthalmic practice at Stony Brook University Medical Center, Suffolk County, New York, a region hyper-endemic for LD. Results: Lyme enzyme-linked immunosorbent assay (ELISA) was positive in 28 (6.4%) patients with optic neuritis, three of whom had syphilis with cross-reactive antibodies. Among the remaining 25 ELISA-positive patients, optic neuritis could be confidently attributed to LD in only one case, a patient with papillitis. The other 24 cases had reactive Lyme serologies related to a history of LD years earlier, asymptomatic exposure, false-positive results, or non-specific humoral expansion. The ELISA in these 24 cases were weakly positive and the Western blots were negative by Centers for Disease Control criteria. There were no significant clinical differences between the 25 seropositive optic neuritis cases and 50 seronegative optic neuritis cases. Conclusions: Based on these cases and a review of the literature, there is insufficient evidence for a causal link between LD and retrobulbar optic neuritis or neuroretinitis. There is sufficient evidence to establish a causal link between LD and papillitis and posterior uveitis.

Original languageEnglish (US)
Pages (from-to)71-82
Number of pages12
JournalJournal of Neuro-Ophthalmology
Volume25
Issue number2
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

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Optic Neuritis
Serology
Lyme Disease
Papilledema
Enzyme-Linked Immunosorbent Assay
Posterior Uveitis
Retinitis
Endemic Diseases
Syphilis
Centers for Disease Control and Prevention (U.S.)
Western Blotting
Antibodies

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Clinical Neurology

Cite this

Sibony, Patrick ; Halperin, John ; Coyle, P. K. ; Patel, Kartik. / Reactive Lyme serology in optic neuritis. In: Journal of Neuro-Ophthalmology. 2005 ; Vol. 25, No. 2. pp. 71-82.
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Reactive Lyme serology in optic neuritis. / Sibony, Patrick; Halperin, John; Coyle, P. K.; Patel, Kartik.

In: Journal of Neuro-Ophthalmology, Vol. 25, No. 2, 01.01.2005, p. 71-82.

Research output: Contribution to journalArticle

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