title: No Value for Routine Serologic Screening for Borrelia burgdorferi in Patients With Uveitis in the Netherlands.
abstract: To determine whether routine serologic screening for Borrelia burgdorferi and subsequent aqueous or vitreous humor analysis is useful in patients with uveitis.
  
  
  
  Cross-sectional study.
  
  
  
  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 for Borrelia 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 for B burgdorferi. The seroprevalence of B burgdorferi among patients with uveitis was compared to the general population.
  
  
  
  Borrelia burgdorferi screening was performed in 1126 uveitis patients (44.3% male, mean age 45.9 ± 19.6 years). The seroprevalence of B burgdorferi among 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.
  
  
  
  The prevalence of immunoblot-confirmed B burgdorferi IgG 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 for Borrelia in uveitis patients.
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Hawkar
authors.initials: H
authors.lastname: Kazi
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: J.D.F.deGroot@umcutrecht.nl.
authors.forename: Jolanda D F
authors.initials: JDF
authors.lastname: de Groot-Mijnes
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Ninette H
authors.initials: NH
authors.lastname: Ten Dam-van Loon
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Ossewaarde-van Norel
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Jan Jelrik
authors.initials: JJ
authors.lastname: Oosterheert
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Joke H
authors.initials: JH
authors.lastname: de Boer
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D001082:Aqueous Humor / Q000382:microbiology; D025065:Borrelia burgdorferi / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015151:Immunoblotting; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008193:Lyme Disease / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D014605:Uveitis / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M