Abstract
Purpose :
Lyme disease, caused by infection with the bacteria Borrelia burgdorferi, is associated with a risk of severe post-treatment symptoms, including ocular complaints. The purpose of this study is to determine the association of Contrast Sensitivity (CS), and Visual Acuity (VA) with ocular complaints in a cohort of patients with post-treatment Lyme disease syndrome (PTLDS).
Methods :
Sixty-one of 86 enrolled in a cohort study of patients with medical-record confirmed prior Lyme disease meeting the proposed case definition for PTLDS had CS measured using a Pelli-Robson chart with forced choice procedures. Patients must have correctly identified 2/3 letters in each triplet to get credit, and the number of letters correct was recorded. Visual Acuity was measured in each eye using ETDRS charts and procedures, with number of letters read correctly recorded. Patients were interviewed regarding presence and severity of visual and other physical symptoms. Bivariate analyses examined the association of ocular complaints with CS, difference in CS between eyes, and VA. Logistic regression models predicting ocular complaints were created to test associations with VA and CS.
Results :
Patients ranged in age from 19 to 80 years (mean=47.3 years), and 55.7% were female. A proportion of patients reported “moderate” or “severe” levels of light sensitivity (27.9%), changes in vision clarity (21.3%), and double vision (4.9%). No patients had bilateral vision worse than 20/70, and over 90% of eyes had VA better than 20/40. Neither visual acuity, nor the difference between eyes in visual acuity, was associated with any reported visual symptoms. However, 36.1% of patients had at least one eye with abnormal CS, and 8.2% had both eyes abnormal. For every loss of a letter in average CS, the odds of reporting double vision increased by 78.2% (p=0.048). CS was not related to the other two visual complaints.
Conclusions :
Visual complaints are common in patients with PTLDS, and are not associated with VA. Lower CS was associated with complaints of double vision, but not clarity or sensitivity to light. Further visual tests may be indicated in this population.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.