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https://doi.org/10.21860/medflum2019_218801

Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) – a possible clinical picture of Ocular Borreliosis: case report

Tvrtka Benašić orcid id orcid.org/0000-0002-1563-7974 ; Zavod za oftalmologiju, Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska
Maja Vinković ; Zavod za oftalmologiju, Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska
Andrijana Kopić orcid id orcid.org/0000-0003-1587-298X ; Zavod za oftalmologiju, Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska
Nenad Vukojević ; Klinika za očne bolesti, Medicinski fakultet, Sveučilište u Zagrebu, Zagreb, Hrvatska
Krešimir Mandić ; Klinika za očne bolesti, Medicinski fakultet, Sveučilište u Zagrebu, Zagreb, Hrvatska
Dubravka Biuk ; Zavod za oftalmologiju, Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Hrvatska


Puni tekst: hrvatski pdf 3.409 Kb

str. 167-173

preuzimanja: 570

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Sažetak

Aim: To present a case report of a patient with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with borreliosis. Case report: A 16-year-old male patient presented with a heavy visual acuity loss on the right eye (BCVA 0.01 on Snellen chart) and occipital headache that lasted a few days. He recalled a bite of an unknown bug and a skin rash around it. Acute chorioretinitis was present bilaterally. Optical coherence tomography (OCT), OCT-angiography (OCTA), visual field (VF), fluorescein angiography (FA), indocyanine green angiography (ICGA), complete laboratory, chest x ray, brain magnetic resonance imaging (MRI). Infectologist and neuropediatric examination and consultation were made. The diagnosis of APMPPE was established and the oral therapy was induced (methylprednisolone 0.5 mg/
kg/day and doxycycline 2x100 mg/day). Elevated titres of IgM and IgG antibodies to Borrelia spp. were found on Enzyme Linked Immuno Sorbent Assay (ELISA) and confirmed by western-blot. A quick restoration of the clinical picture and visual acuity up to 0.75 were noticed after the administration of the therapy. Conclusions: It is important to emphasize that in the case of APMPPE it is necessary to exclude concomitant infections, especially ocular borreliosis, particularly in the case of a tick or any bug bite, even in cases when the patients do not remember the bug bite. In those circumstances the prompt therapy of APMPPE and borreliosis assures proper treatment, which diminishes ocular or systemic complications.

Ključne riječi

Borrelia, Chorioretinitis, Lyme disease

Hrčak ID:

218801

URI

https://hrcak.srce.hr/218801

Podaci na drugim jezicima: hrvatski

Posjeta: 1.089 *