Transcript Folie 1 - Springer Static Content Server

Leptospirosis
Dr. Rathinam Sivakumar
HOD - Uveitis Services
Dr. Radhika. T
Consultant, Uveitis Service
Dr. Vedhanayaki Rajesh
Consultant, Uveitis Service
Ocular History
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27 year old male
OS:
defective vision & floaters since 6 months
pain and redness – on & off
occupation: agriculture
H/o exposure to rats
First Presentation
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VA: OD 6/12, OS 6/6
IOP: OD 14mm Hg; OS 10mm Hg
OD:
non-granulomatous KP's, AC 3+cells; hypopyon
AVF – vit. haze 2+ with vit. membranes
fundus: dense vitritis, hyperaemic disc, vasculitis
OS: quiet eye
Investigations
 Routine baseline investigations
(TC,DC,ESR,Mantoux and TPHA)
within normal limits
 Leptospirosis microagglutination test
(positive in 1: 100 dilution)
Diagnosis
 non-granulomatous panuveitis
 due to leptospirosis
Therapy
 Steroid eye drops– tapering therapy
 Oral Doxycyclin (100mg) twice/day
for 10 days
 Oral Prednisolone tapered weekly from
40mg/week to 10mg (4 weeks)
 Inj. Triamcinolone acetonide 0.5cc given
Follow Up – After 1 Month
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VA: OD 6/6, OS 6/6
IOP: OD 17mm Hg; OS 17mm Hg
OD:
AC – Quiet; AVF – Occ. Cells
OS: Quiet eye
Conclusion - Leptospiral Uveitis
 water borne spirochaetal systemic infection
 spread from animal to human with increased risk
among people exposed to leptospiral contaminated
water or soil
 systemic picture can vary from hepato-renal
dysfunction to mild fever with arthralgia
 non-granulomatous panuveitis with hypopyon,
membranous vitreous opacities, papillitis and
vasculitis are significant ocular signs
 carries good prognosis