Leptospiral Uveitis: Case Series and Review of Literature

Ocul Immunol Inflamm. 2023 Dec 21:1-9. doi: 10.1080/09273948.2023.2296037. Online ahead of print.

Abstract

Aim: To present the clinical features and review of literature of leptospiral uveitis.

Methods: We present clinical features of patients with leptospiral uveitis with positive Leptospira IgM antibodies.

Results: Twenty-six eyes of 24 patients, 11 males (45.8%), were included. The mean age was 37.5 ± 15.6 years. 91.7% had unilateral uveitis, 88.5% panuveitis, 11.5% anterior uveitis, 15.4% had hypopyon, 8% had cataract and 3.8% eyes had cystoid macular edema. Vitritis with characteristic vitreous membranes was an important feature. Retinal and choroidal vasculature were preserved on swept-source optical coherence tomography angiography. Mean presenting BCVA was logMAR0.49 ± 0.41, while final BCVA was logMAR0.04 ± 0.13. The mean duration for complete resolution of uveitis was 39.1 ± 15.5 days. 84.6% eyes achieved BCVA 6/6.

Conclusion: Leptospiral uveitis is an under-reported entity. It may present as anterior uveitis or panuveitis. It must be included in the differential diagnosis of non-granulomatous uveitis. The visual prognosis is usually favorable even in severe cases.

Keywords: Human leptospirosis; leptospiral uveitis; leptospirosis; ocular leptospirosis; zoonosis.