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Spirochetal uveitis: Spectrum of clinical manifestations, diagnostic and therapeutic approach, final outcome and epidemiological data

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Abstract

Purpose

Analysis of cases with spirochetal uveitis related to spirochetes in a tertiary referral academic center.

Methods

Retrospective study of patients diagnosed with uveitis attributed to Treponema pallidum, Leptospira spp. and Borrelia burgdorferi from June 1991 until December 2019.

Results

A total of 57 cases of spirochetal uveitis (22 patients with T. pallidum, 26 with Leptospira spp., and 9 with B. burgdorferi) that consisted 1% of the overall number of uveitics were recorded. All these cases presented with a wide spectrum of clinical presentations (anterior uveitis, posterior uveitis, panuveitis, vasculitis, papillitis, and in some rare cases concomitant posterior scleritis). The treatment included mainly penicillin or doxycycline, while corticosteroids were administered systematically in some cases with Borrelia or Leptospira infection. The final visual outcome was favorable (> 6/10 in Snellen visual acuity) in approximately 76% of our patients.

Conclusion

Despite being rare, spirochetal uveitis can be detrimental for the vision and must always be included in the differential diagnosis.

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Availability of data and material

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

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Acknowledgements

Special thanks to: Hellenic Pasteur Institute of Athens for their kind collaboration and support. Ms. Kalliopi Zoumpa (Secretary of Professor C. Kalogeropoulos, Head of Ocular Inflammation Service) for her valuable assistance in the collection of imaging data from our archives.

Funding

All authors declare that they received no funding for this study.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavros Niarchos Ave, 45500, Ioannina, Greece

    Dimitrios Kalogeropoulos, Ioannis Asproudis, Maria Stefaniotou, Konstantinos Malamos & Chris Kalogeropoulos

  2. 1St Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Marilita Moschos

  3. Laboratory of Microbiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Constantina Gartzonika

  4. Department of Skin & Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Ioannis Bassukas & Georgios Gaitanis

  5. Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Spiros Konitsiotis

  6. 1St Division of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Haralampos Milionis

Authors
  1. Dimitrios Kalogeropoulos
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Contributions

All authors participated in the planning, research and writing of the final manuscript, as well as reviewing and rewriting of the revised version.

Corresponding author

Correspondence to Dimitrios Kalogeropoulos.

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Conflict of interest

All authors declare that there is no conflict of interest.

Ethical approval

The research followed the tenets of the Declaration of Helsinki. The Scientific Committee of the University Hospital of Ioannina (Greece) approved the current study on the 30th of January 2019 (Protocol number 1514).

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The Corresponding Author, has the right to assign on behalf of all authors and does assign on behalf of all authors, a full assignment of all intellectual property rights for all content within the submitted study in any media known now or created in the future, and permits this study (if accepted) to be published and to be fully exploited within the remit of the assignment as set out in the assignment which has been read.

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Kalogeropoulos, D., Asproudis, I., Stefaniotou, M. et al. Spirochetal uveitis: Spectrum of clinical manifestations, diagnostic and therapeutic approach, final outcome and epidemiological data. Int Ophthalmol 41, 4111–4126 (2021). https://doi.org/10.1007/s10792-021-01984-x

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