Abstract
Systemic infectious diseases can affect various organ systems including the ocular tissue. Organisms such as bacteria, viruses, fungi, and parasites can disseminate from their systemic foci of infection and involve the retinal and the choroid. Retinochoroidal involvement due to systemic infectious conditions can present with protean clinical manifestations and can often result in a diagnostic challenge. Often, these entities can present with unusual ocular findings. Thus, the clinician may need advanced laboratory support including analysis of ocular fluids and/or tissues to establish accurate diagnosis. In the past few decades, there have been numerous advances in the field of ocular imaging. With the introduction of newer imaging modalities such as enhanced-depth imaging optical coherence tomography and ultrawide-field fundus photography, it is possible to obtain high-quality near-histological images of the retina and choroid. Such observations can greatly aid the clinician in establishing the diagnosis early. In the index chapter, infectious chorioretinal diseases such as tuberculosis, toxoplasmosis, Lyme disease, and syphilis have been described with an emphasis on their clinical and imaging features.
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References
Singh R, Gupta V, Gupta A. Pattern of uveitis in a referral eye clinic in north India. Indian J Ophthalmol. 2004;52(2):121–5.
Gupta A, Gupta V. Tubercular posterior uveitis. Int Ophthalmol Clin. 2005;45(2):71–88.
Hooper C, McCluskey P. Intraocular inflammation: its causes and investigations. Curr Allergy Asthma Rep. 2008;8(4):331–8.
WHO. Guidelines on the management of latent tuberculosis infection. Geneva: World Health Organization; 2015.
Global Health Observatory (GHO) data. 2014. http://www.who.int/gho/tb/en/. Accessed 27 Apr 2016.
Behr MA, Waters WR. Is tuberculosis a lymphatic disease with a pulmonary portal? Lancet. 2014;14(3):250–5.
Narendran G, Swaminathan S. TB-HIV co-infection: a catastrophic comradeship. Oral Dis. 2016;22(Suppl 1):46–52.
Balasubramanian V, Wiegeshaus EH, Taylor BT, Smith DW. Pathogenesis of tuberculosis: pathway to apical localization. Tuber Lung Dis. Jun 1994;75(3):168–78.
Lara LP, Ocampo V Jr. Prevalence of presumed ocular tuberculosis among pulmonary tuberculosis patients in a tertiary hospital in the Philippines. J Ophthal Inflamm Infect. 2013;3(1):1.
Gupta V, Shoughy SS, Mahajan S, et al. Clinics of ocular tuberculosis. Ocul Immunol Inflamm. 2015;23(1):14–24.
Gupta V, Gupta A, Rao NA. Intraocular tuberculosis--an update. Surv Ophthalmol. 2007;52(6):561–87.
Gupta A, Bansal R, Gupta V, Sharma A, Bambery P. Ocular signs predictive of tubercular uveitis. Am J Ophthalmol. 2010;149(4):562–70.
Bansal R, Gupta A, Gupta V, Dogra MR, Sharma A, Bambery P. Tubercular serpiginous-like choroiditis presenting as multifocal serpiginoid choroiditis. Ophthalmology. 2012;119(11):2334–42.
Gupta V, Gupta A, Arora S, Bambery P, Dogra MR, Agarwal A. Presumed tubercular serpiginouslike choroiditis: clinical presentations and management. Ophthalmology. 2003;110(9):1744–9.
Nazari Khanamiri H, Rao NA. Serpiginous choroiditis and infectious multifocal serpiginoid choroiditis. Surv Ophthalmol. 2013;58(3):203–32.
Zhang M, Zhang J, Liu Y. Clinical presentations and therapeutic effect of presumed choroidal tuberculosis. Retina. 2012;32(4):805–13.
Biswas J, Madhavan HN, Gopal L, Badrinath SS. Intraocular tuberculosis. Clinicopathologic study of five cases. Retina. 1995;15(6):461–8.
Babu RB, Sudharshan S, Kumarasamy N, Therese L, Biswas J. Ocular tuberculosis in acquired immunodeficiency syndrome. Am J Ophthalmol. 2006;142(3):413–8.
Sudharshan S, Kaleemunnisha S, Banu AA, et al. Ocular lesions in 1,000 consecutive HIV-positive patients in India: a long-term study. J Ophthalm Inflamm Infect. 2013;3(1):2.
Gupta A, Bansal R, Gupta V, Sharma A. Fundus autofluorescence in serpiginouslike choroiditis. Retina. 2012;32(4):814–25.
Aggarwal K, Mulkutkar S, Mahajan S, et al. Role of ultra-wide field imaging in the management of tubercular posterior uveitis. Ocul Immunol Inflamm. 2016;6:1–6.
Wolfensberger TJ, Piguet B, Herbort CP. Indocyanine green angiographic features in tuberculous chorioretinitis. Am J Ophthalmol. 1999;127(3):350–3.
De Luigi G, Mantovani A, Papadia M, Herbort CP. Tuberculosis-related choriocapillaritis (multifocal-serpiginous choroiditis): follow-up and precise monitoring of therapy by indocyanine green angiography. Int Ophthalmol. 2012;32(1):55–60.
Invernizzi A, Agarwal A, Cozzi M, Viola F, Nguyen QD, Staurenghi G. Enhanced depth imaging optical coherence tomography features in areas of choriocapillaris hypoperfusion. Retina. 2016;36(10):2013–21.
Punjabi OS, Rich R, Davis JL, et al. Imaging serpiginous choroidopathy with spectral domain optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2008;39(4 Suppl):S95–8.
Rifkin LM, Munk MR, Baddar D, Goldstein DA. A new OCT finding in tuberculous serpiginous-like choroidopathy. Ocul Immunol Inflamm. 2015;23(1):53–8.
Bansal R, Kulkarni P, Gupta A, Gupta V, Dogra MR. High-resolution spectral domain optical coherence tomography and fundus autofluorescence correlation in tubercular serpiginouslike choroiditis. J Ophthalm Inflamm Infect. 2011;1(4):157–63.
Salman A, Parmar P, Rajamohan M, Vanila CG, Thomas PA, Jesudasan CA. Optical coherence tomography in choroidal tuberculosis. Am J Ophthalmol. 2006;142(1):170–2.
Invernizzi A, Mapelli C, Viola F, et al. Choroidal granulomas visualized by enhanced depth imaging optical coherence tomography. Retina. 2015;35(3):525–31.
Mandadi SK, Agarwal A, Aggarwal K, Moharana B, Singh R, Sharma A, Bansal R, Dogra MR, Gupta V. For OCTA Study Group. Novel findings on optical coherence tomography angiography in patients with tubercular serpiginous-like choroiditis. Retina. 2016 Dec 7. [Epub ahead of print].
Yee HYM, Keane PAF, Ho SLF, Agrawal RF. Optical coherence tomography angiography of choroidal neovascularization associated with tuberculous serpiginous-like choroiditis. Ocular Immunol Inflamm. 2016;30:1–3.
Marks SM, Hirsch-Moverman Y, Salcedo K, et al. Characteristics and costs of multidrug-resistant tuberculosis in-patient care in the United States, 2005–2007. IntJ Tuber Lung Dis. 2016;20(4):435–41.
Tiberi S, Sotgiu G, D’Ambrosio L, et al. Comparison of effectiveness and safety of imipenem/clavulanate- versus meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB. Eur Respir J. 2016;47(6):1758–66.
Sotgiu G, D’Ambrosio L, Centis R, et al. Carbapenems to treat multidrug and extensively drug-resistant tuberculosis: a systematic review. Int J Mol Sci. 2016;17(3):373.
Sharma K, Sharma A, Bansal R, Fiorella PD, Gupta A. Drug-Resistant Tubercular Uveitis. J Clin Microbiol. Nov 2014;52(11):4113–4.
Gupta V, Bansal R, Gupta A. Continuous progression of tubercular serpiginous-like choroiditis after initiating antituberculosis treatment. Am J Ophthalmol. 2011;152(5):857–863.e852.
Eickhoff CA, Decker CF. Syphilis. Dis Mon. 2016;62:280–6.
Mitja O, Asiedu K, Mabey D. Yaws. Lancet. 2013;381(9868):763–73.
Berger JR, Dean D. Neurosyphilis. Handb Clin Neurol. 2014;121:1461–72.
Lynn WA, Lightman S. Syphilis and HIV: a dangerous combination. Lancet. 2004;4(7):456–66.
Centers for Disease Control and Prevention (CDC). Outbreak of syphilis among men who have sex with men--Southern California, 2000. MMWR Morb Mortal Wkly Rep. 2001;50(7):117–20.
Davis JL. Ocular syphilis. Curr Opin Ophthalmol. 2014;25(6):513–8.
Yang P, Zhang N, Li F, Chen Y, Kijlstra A. Ocular manifestations of syphilitic uveitis in Chinese patients. Retina. 2012;32(9):1906–14.
Doris JP, Saha K, Jones NP, Sukthankar A. Ocular syphilis: the new epidemic. Eye. 2006;20(6):703–5.
Chao JR, Khurana RN, Fawzi AA, Reddy HS, Rao NA. Syphilis: reemergence of an old adversary. Ophthalmology. 2006;113(11):2074–9.
Eandi CM, Neri P, Adelman RA, Yannuzzi LA, Cunningham ET Jr. Acute syphilitic posterior placoid chorioretinitis: report of a case series and comprehensive review of the literature. Retina. 2012;32(9):1915–41.
Matsumoto Y, Spaide RF. Autofluorescence imaging of acute syphilitic posterior placoid chorioretinitis. Retinal Cases Brief Rep. 2007;1(3):123–7.
Brito P, Penas S, Carneiro A, Palmares J, Reis FF. Spectral-domain optical coherence tomography features of acute syphilitic posterior placoid chorioretinitis: the role of autoimmune response in pathogenesis. Case Rep Ophthalmol. 2011;2(1):39–44.
Pichi F, Ciardella AP, Cunningham ET Jr, et al. Spectral domain optical coherence tomography findings in patients with acute syphilitic posterior placoid chorioretinopathy. Retina. 2014;34(2):373–84.
Clement ME, Okeke NL, Hicks CB. Treatment of syphilis: a systematic review. JAMA. 2014;312(18):1905–17.
Lane RS, Piesman J, Burgdorfer W. Lyme borreliosis: relation of its causative agent to its vectors and hosts in North America and Europe. Annu Rev. Entomol. 1991;36:587–609.
Steere AC. Lyme disease. N Engl J Med. 2001;345(2):115–25.
Bacon RM, Kugeler KJ, Mead PS. Surveillance for Lyme disease--United States, 1992–2006. Morb Mortal Wkly Rep. 2008;57(10):1–9.
Nelson CA, Saha S, Kugeler KJ, et al. Incidence of clinician-diagnosed lyme disease, United States, 2005–2010. Emerg Infect Dis. 2015;21(9):1625–31.
Cimmino MA, Fumarola D, Sambri V, Accardo S. The epidemiology of Lyme borreliosis in Italy. Microbiologica. 1992;15(4):419–24.
Christova I, Komitova R. Clinical and epidemiological features of Lyme borreliosis in Bulgaria. Wien Klin Wochenschr. 2004;116(1–2):42–6.
Bleyenheuft C, Lernout T, Berger N, et al. Epidemiological situation of Lyme borreliosis in Belgium, 2003 to 2012. Arch Public Health. 2015;73(1):33.
Dou XF, Lyu YN, Jiang Y, et al. Lyme borreliosis-associated risk factors in residents of Beijing suburbs: a preliminary case-control study. Biomed Environ Sci. 2014;27(10):807–10.
Jairath V, Sehrawat M, Jindal N, Jain VK, Aggarwal P. Lyme disease in Haryana, India. Ind J Dermatol Venereol Leprol. 2014;80(4):320–3.
Sanchez JL. Clinical manifestations and treatment of lyme disease. Clin Lab Med. 2015;35(4):765–78.
Hoppa E, Bachur R. Lyme disease update. Curr Opin Pediatr. 2007;19(3):275–80.
Chomel B. Lyme disease. Rev Sci Tech. 2015;34(2):569–76.
Halperin JJ. Chronic Lyme disease: misconceptions and challenges for patient management. Infect Drug Resist. 2015;8:119–28.
Raja H, Starr MR, Bakri SJ. Ocular manifestations of tick-borne diseases. Surv Ophthalmol. 2016;61(6):726–44.
Winterkorn JM. Lyme disease: neurologic and ophthalmic manifestations. Surv Ophthalmol. 1990;35(3):191–204.
Balcer LJ, Winterkorn JM, Galetta SL. Neuro-ophthalmic manifestations of Lyme disease. J Neuroophthalmol. 1997;17(2):108–21.
Bergloff J, Gasser R, Feigl B. Ophthalmic manifestations in Lyme borreliosis. A review. J Neuroophthalmol. 1994;14(1):15–20.
Park M. Ocular manifestations of Lyme disease. J Am Optom Assoc. 1989;60(4):284–9.
Lardenoye CW, Van der Lelij A, de Loos WS, Treffers WF, Rothova A. Peripheral multifocal chorioretinitis: a distinct clinical entity? Ophthalmology. 1997;104(11):1820–6.
Singh RS, Tran LH, Kim JE. Acute exudative polymorphous vitelliform maculopathy in a patient with Lyme disease. Ophthal Surg Lasers Imag Retina. 2013;44(5):493–6.
Karma A, Mikkila H. Ocular manifestations and treatment of Lyme disease. Curr Opin Ophthalmol. 1996;7(3):7–12.
Karma A, Seppala I, Mikkila H, Kaakkola S, Viljanen M, Tarkkanen A. Diagnosis and clinical characteristics of ocular Lyme borreliosis. Am J Ophthalmol. 1995;119(2):127–35.
Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43(9):1089–134.
Wright WF, Riedel DJ, Talwani R, Gilliam BL. Diagnosis and management of Lyme disease. Am Fam Physician. 2012;85(11):1086–93.
Bratton RL, Whiteside JW, Hovan MJ, Engle RL, Edwards FD. Diagnosis and treatment of Lyme disease. Mayo Clin Proc. 2008;83(5):566–71.
Mogollon-Pasapera E, Otvos L Jr, Giordano A, Cassone M. Bartonella: emerging pathogen or emerging awareness? Int J Infect Dis. 2009;13(1):3–8.
Pretorius AM, Kelly PJ. An update on human bartonelloses. Central African J Med. 2000;46(7):194–200.
McElroy KM, Blagburn BL, Breitschwerdt EB, Mead PS, McQuiston JH. Flea-associated zoonotic diseases of cats in the USA: bartonellosis, flea-borne rickettsioses, and plague. Trends Parasitol. 2010;26(4):197–204.
Ulug M. Evaluation of cat scratch disease cases reported from Turkey between 1996 and 2013 and review of the literature. Cent Eur J Public Health. 2015;23(2):170–5.
Picascia A, Pagliuca C, Sommese L, et al. Seroprevalence of Bartonella henselae in patients awaiting heart transplant in southern Italy. J Microbiol Immunol Infect. 2017;50(2):239–44.
Maguina C, Guerra H, Ventosilla P. Bartonellosis. Clin Dermatol. 2009;27(3):271–80.
Batsakis JG, Ro JY, Frauenhoffer EE. Bacillary angiomatosis. Ann Otol Rhinol Laryngol. 1995;104(8):668–72.
Crocetti D, Palmieri A, Pedulla G, Pasta V, D’Orazi V, Grazi GL. Peliosis hepatis: personal experience and literature review. World J Gastroenterol. 2015;21(46):13188–94.
DeLeve LD. Vascular liver diseases. Curr Gastroenterol Rep. 2003;5(1):63–70.
Lezrek O, Laghmari M, Jait A, El Atiqi A, Lezrek M, Daoudi R. Neuroretinitis in ocular bartonellosis. J Pediatr. 2015;166(2):496–496.e491.
Ormerod LD, Skolnick KA, Menosky MM, Pavan PR, Pon DM. Retinal and choroidal manifestations of cat-scratch disease. Ophthalmology. 1998;105(6):1024–31.
Biancardi AL, Curi AL. Cat-scratch disease. Ocul Immunol Inflamm. 2014;22(2):148–54.
Matsuo T, Yamaoka A, Shiraga F, et al. Clinical and angiographic characteristics of retinal manifestations in cat scratch disease. Jpn J Ophthalmol. 2000;44(2):182–6.
Curi AL, Machado DO, Heringer G, Campos WR, Orefice F. Ocular manifestation of cat-scratch disease in HIV-positive patients. Am J Ophthalmol. 2006;141(2):400–1.
Gray AV, Reed JB, Wendel RT, Morse LS. Bartonella henselae infection associated with peripapillary angioma, branch retinal artery occlusion, and severe vision loss. Am J Ophthalmol. 1999;127(2):223–4.
Mason JO III. Retinal and optic nerve neovascularization associated with cat scratch neuroretinitis. Retina. 2004;24(1):176–8.
Latanza L, Viscogliosi F, Solimeo A, Calabro F, De Angelis V, De Rosa PS. Choroidal neovascularisation as an unusual ophthalmic manifestation of cat-scratch disease in an 8-year-old girl. Int Ophthalmol. 2015;35(5):709–16.
Manousaridis K, Peter S, Mennel S. Cat-scratch-disease-associated macular oedema treated with intravitreal ranibizumab. Acta Ophthalmol. 2015;93(2):e168–70.
Empeslidis T, Tsaousis KT, Konidaris V, Pradeep A, Deane J. Multifocal chorioretinitis caused by Bartonella henselae: imaging findings of spectral domain optical coherence tomography during treatment with trimethoprim-sulfamethoxazole. Eye. 2014;28(7):907–9.
Prutsky G, Domecq JP, Mori L, et al. Treatment outcomes of human bartonellosis: a systematic review and meta-analysis. Int J Infect Dis. 2013;17(10):e811–9.
Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D. Recommendations for treatment of human infections caused by Bartonella species. Antimicrob Agents Chemother. 2004;48(6):1921–33.
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The authors have no financial disclosure/proprietary interest. No conflicting relationship exists for any author.
This work was partly supported by a grant from the Department of Science and Technology, India, for the development of Centre of Excellence at the Advanced Eye Centre, PGIMER, Chandigarh.
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Agarwal, A., Gupta, V. (2018). Systemic Infectious Diseases. In: Chhablani, J., Majumder, P., Arevalo, J. (eds) Retinal and Choroidal Imaging in Systemic Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-10-5461-7_9
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