Leptospira, the ocular predator

Abstract

Neuroretinitis is an inflammatory optic neuropathy with a classic funduscopic appearance of optic disc swelling and hard exudates on the macula in a star formation. It can be a manifestation of systemic, infectious or autoimmune disease. Here, we report three patients who presented with sudden onset of painless blurring of vision. Ophthalmic evaluation revealed a characteristic picture of neuroretinitis. Detailed study of the cases revealed leptospirosis being the aetiology of the neuroretinitis. Leptospirosis is a zoonotic infection caused by spirochetes Leptospira, which presents with both ocular and systemic manifestations. Neuroretinitis has been reported in the few cases of leptospirosis. We present three cases of leptospirosis with bilateral and unilateral neuroretinitis presenting with sudden loss of vision, optic disc oedema, and macular star. Leptospirosis was confirmed by serological test and the disease responded optimally to specific therapy. Although funduscopic examination showed marked inflammatory changes in the retina and optic nerve head, the recovery following medical treatment was remarkable.