Winward K E, Smith J L, Culbertson W W, Paris-Hamelin A
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33101.
Am J Ophthalmol. 1989 Dec 15;108(6):651-7. doi: 10.1016/0002-9394(89)90856-8.
In six patients with ocular Lyme borreliosis, bilateral granulomatous iridocyclitis and vitritis were present in five. One of these five also had bilateral optic neuritis. Another patient developed combined trochlear and facial nerve palsies. A syndrome resembling pars planitis with atypical features such as granulomatous keratic precipitates and posterior synechiae should prompt a search for Lyme borreliosis. Topical corticosteroid therapy is necessary to prevent complications of anterior segment inflammation caused by Lyme uveitis, but the benefit of systemic and periocular corticosteroids is uncertain. Oral antibiotics may be effective in treating early stages of ocular Lyme borreliosis. In later stages, intravenous antibiotic therapy is indicated.
在6例眼部莱姆病患者中，5例出现双侧肉芽肿性虹膜睫状体炎和葡萄膜炎。这5例中的1例还患有双侧视神经炎。另1例患者出现滑车神经和面神经联合麻痹。一种类似中间葡萄膜炎的综合征，伴有肉芽肿性角膜后沉着物和虹膜后粘连等非典型特征，应促使医生排查莱姆病。局部使用皮质类固醇疗法对于预防莱姆葡萄膜炎引起的前段炎症并发症是必要的，但全身和眼周使用皮质类固醇的益处尚不确定。口服抗生素可能对治疗眼部莱姆病的早期有效。在后期，则需进行静脉抗生素治疗。
