No Value for Routine Serologic Screening for B orrelia burgdorferi in Patients With Uveitis in the Netherlands

• Published in: American journal of ophthalmology 2016-06, Vol.166, p.189-193
• Main Authors: Kazi, Hawkar, de Groot-Mijnes, Jolanda D.F., ten Dam-van Loon, Ninette H., Ossewaarde-van Norel, Jeannette, Oosterheert, Jan Jelrik, de Boer, Joke H.
• Format: Article
• Language: English
• Subjects: Arachnids; Classification; Family medical history; Fluids; Funding; Immunoglobulins; Laboratories; Lyme disease; Patients; Streptococcus infections; Syphilis
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2016.04.002

Purpose To determine whether routine serologic screening forBorrelia burgdorferiand subsequent aqueous or vitreous humor analysis is useful in patients with uveitis. Design Cross-sectional study. Methods All patients referred to our tertiary uveitis referral clinic in the period of from January 1, 2004 to October 31, 2014, in whom routine serologic screening forBorrelia burgdorferi(IgG as determined by enzyme-linked immunosorbent assay and confirmed by immunoblot) was performed were retrospectively reviewed. In patients with an unclassified uveitis, aqueous and vitreous humor and cerebrospinal fluid were also analyzed. Local antibody production was determined by Goldmann-Witmer coefficient calculation or polymerase chain reaction forB burgdorferi. The seroprevalence ofB burgdorferiamong patients with uveitis was compared to the general population. Results Borrelia burgdorferiscreening was performed in 1126 uveitis patients (44.3% male, mean age 45.9 ± 19.6 years). The seroprevalence ofB burgdorferiamong uveitis patients was 3.7% (95% confidence interval 2.6%-4.8%) (n = 42) as compared to 5%-10% in the general Dutch population. Of these 42 patients, 14 (1.2% of all uveitis patients) had an unclassified uveitis, 7 of whom underwent aqueous humor (n = 5) or vitreous humor (n = 2) analysis and cerebrospinal fluid analysis (n = 2). None of the patients had local antibody production in either ocular or cerebrospinal fluid. Conclusion The prevalence of immunoblot-confirmedB burgdorferiIgG seropositivity in our uveitis patients is only slightly lower as compared to the general Dutch population. Intraocular antibody production and DNA was absent in all tested patients. These findings do not support routine serologic examination forBorreliain uveitis patients.