莱姆病的眼底表现及其治疗

Fundus manifestations and treatment of Lyme disease

莱姆病系由硬蜱传播包柔螺旋体所引起的一种全身性疾病,可累及眼部多个部位而致视力丧失。1989年以来收治了51例,88只眼,其眼底表现以视网膜血管炎合并增殖性改变为主。依据病史、检查和血清莱姆病抗体(≥1∶128)作出诊断。3例玻璃体发现螺旋体。采用玻璃体切除术(11只眼)、氩离子激光(27只眼)和先锋霉素V等药物综合治疗,莱姆病抗体阴转率约80％,致盲率45.1％。

Lyme disease is a tick-borne systemic borreliosis involving various parts of the body and the eyes. Since 1989 51 cases (88 eyes)of the disease have been treated in Tong Ren Hospital and fundus manifestations were mainly retinal vasculitis complicated by proliferative lesions. The diagnosis was based on history of the illness clinical examinations, and serum antibody titer of 1:128 or over against B. Burgdorferi Spirocheates were found in 3 vitreous specimens. The patients were treated with antibiotics and, when indicated, Argon laser photocoagulation (27 eyes) and vitrectomy (11 eyes), Serum antibodies turned negative in about 80％of the cases after treatment. The blinding rate was 45. 4％.