Uveitis associated with an epidemic outbreak of leptospirosis.
OBJECTIVE
To define uveitis associated with leptospirosis in a clinical setting.


METHODS
We present the clinical features of 73 consecutive cases of uveitis linked clinically to an outbreak of systemic leptospirosis in patients with antibodies to Leptospira species who were examined from January to September 1994.


RESULTS
In 73 patients, the pattern of ocular involvement was unilateral in 35 and bilateral in 38. Panuveitis was seen in 106 eyes (95.5%), retinal periphlebitis in 57 eyes (51.4%), and hypopyon in 14 eyes (12.6%). Anterior uveitis alone without hypopyon was observed in three eyes (2.7%), whereas vitreous inflammatory reaction alone was seen in two eyes (1.8%). Sixty of 73 patients (82.2%) or 91 of 111 eyes (82.0%) were followed up for 8 months. Final visual acuity was 6/6 (20/20) in 47 eyes (52%) and improved during treatment, although not up to 6/6, in 15 eyes (16%). Twenty-eight eyes (31%) maintained same vision, and one eye showed deterioration of vision.


CONCLUSIONS
Uveitis associated with leptospirosis may manifest as unilateral or bilateral uveitis, anterior uveitis, or panuveitis. The prognosis is generally good in this entity, even when the inflammation is severe. Awareness of this disease in endemic areas is important in order to differentiate it from other uveitic entities, especially in young male patients in whom other immunologic uveitides are also common.
Rathinam
S R
SR
Aravind Eye Hospital, Madurai, India.
Rathnam
S
S
Selvaraj
S
S
Dean
D
D
Nozik
R A
RA
Namperumalsamy
P
P
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000032:analysis; D004196:Disease Outbreaks; D004318:Doxycycline / Q000627:therapeutic use; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007194:India / Q000453:epidemiology; D007919:Leptospira / Q000276:immunology / Q000302:isolation & purification; D007922:Leptospirosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014605:Uveitis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D014792:Visual Acuity
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D005938:Glucocorticoids; D004318:Doxycycline