Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Borreliosis or Lyme disease, a tick-borne infection with the spirochete Borrelia burgdorferi, can cause various ocular and neurological symptoms. A 41-year-old man had been repeatedly bitten by ticks in June 1992; 6 months later, the patient complained of blurred vision in both eyes of 1-week duration, bifrontal headache that was more pronounced on the right side, and neck pain that had appeared months earlier and was becoming more severe. On ophthalmoscopy, clover-shaped retinal pigment epithelium detachments around the optic disc were observed in both eyes. The patient's visual acuity was reduced to 0.5 in his left eye. Liquor cells and total protein were significantly increased; however, a hemagglutination inhibition test revealed only moderately increased immunoglobulin values. After 2 weeks of daily application of 4 g ceftriaxone disodium, ophthalmological and neurological symptoms disappeared. Even though the immunoglobulin values remained unchanged, neuroborreliosis with involvement of the retinal pigment epithelium was the most probable diagnosis, considering the history of tick bites and headache. The authors assume that the tissue around the optic nerve head, which does not have an effective blood-brain barrier, allowed the spirochetes to spread from the central nervous system into the subpigment-epithelium space, thus causing the observed parapapillary pigment epithelium detachments.
 ...
PMID:Neuroborreliosis with retinal pigment epithelium detachments. 864 73

Neuroborreliosis is a form of borreliosis that affects the central and/or peripheral nervous system. Although it can mimic neurologic and ophthalmologic disorders such as multiple sclerosis and optic neuritis, visual evoked potential (VEP) examination is usually not used in neuroborreliosis diagnostics. Combined VEP testing (pattern-reversal VEPs and VEPs produced in response to linear and radial motion) was performed in 81 patients with neuroborreliosis verified by laboratory results (positive polymerase chain reaction or intrathecal antibodies production). Thirty-four patients reported diplopia or blurred vision related to borreliosis. In 33 (40%) patients the VEPs were delayed: motion-onset VEPs were pathologic in 22 (27%) patients, reversal VEPs in 5 (6%) patients, and both VEP types in 6 (7%) patients. The findings suggest that VEP testing (especially the motion-onset VEP testing) can confirm CNS involvement. Much higher sensitivity of motion-onset VEPs in comparison with reversal VEPs can result from rather selective (earlier) involvement of the magnocellular system or the dorsal stream of the visual pathway.
 ...
PMID:Motion-onset and pattern-reversal visual evoked potentials in diagnostics of neuroborreliosis. 1701 51