Abstract

SO.20.09

Ocular manifestations in patients with infectious diseases

Kirilova Y., Vassileva P.,Tiholova M., Paskaleva D.
Eye hospital “Pashev”, Department of Infectious Diseases, University Hospital, Sofia, Bulgaria

Objective: The etiology of intraocular inflammations may be difficult to establish. It is often associated with systemic infectious diseases. An interdisciplinary study was performed in collaboration with specialists in infectious diseases, parasitology, radiology and pulmonary disease.
Methods: All consecutive patients with intraocular inflammation and presumed systemic infectious disease admitted in Eye Hospital “Pashev” for a period of one year were diagnosed and treated in collaboration with the Department of Infectious diseases at Medical University, Sofia. All 83 patients underwent routine eye exam. Additional diagnostic procedures were performed in most patients: serological tests for infectious and parasitic diseases (toxoplasmosis, toxocarosis, borreliosis, CMV, EBV, HSV, HZV, chlamydia, tuberculosis, syphilis). Specific investigations (FA, B-scan, visual fields, anterior chamber paracentesis with serological tests) were needed in selected cases. All patients filled up an uveitis questionnaire. Diagnosis was established based on clinical data and test results at team discussion.
Results: Altogether 83 patients were included in this study. The average patients age at the onset of eye manifestations was 42,5 years (range from 1 to 83 years). Most common cause of eye infection was Herpes virus – HSV/HZV in 34 patients (41%). In twelve patients (14,5%) ocular toxoplasmosis was proven. Tuberculosis was diagnosed in 6 patients (7,2%) and in 3 (3,6%) –ocular borreliosis (Lyme disease). Relatively rare observations of chlamidia infections (two patients), toxocariosis and tularemia (one of each) were registered. Most beneficial for patients was customized therapeutical regiment designed by team of experts.
Conclusions: The eye involvements in infectious diseases are common and they should receive appropriate and timely treatment. Our study demonstrates that eye manifestations can guide infectious disease specialists to establish the systemic infection, and help ophthalmologists in etiological diagnosis of intraocular inflammation.

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