DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.017

Pages: 2737-2739

Background: Neuroretinitis is an uncommon manifestation of Borrelia burgdorferi infection [1,2]. It typically presents as acute visual loss associated with optic disc edema and macular star [3]. Case Presentation: We report two cases of neuroretinitis secondary to Lyme disease in young women. The first patient, aged 42, presented with acute painless ision loss in the right eye (counting fingers at 3 meters), and the second, aged 35, in the left eye (1/10 on the Monoyer scale). Both had erythema migrans one month prior to ocular symptoms. Fundus examination revealed papillary edema with a macular star, and OCT confirmed macular edema. Serologic testing showed positive Borrelia burgdorferi IgM, while other infectious causes were excluded. MRI findings were unremarkable. The first patient received intravenous ftriaxone and the second doxycycline (due to C3G allergy), combined with high-dose corticosteroids followed by a tapering course over three months. Both showed progressive improvement in visual acuity after three weeks, reaching 5/10 and 7/10 respectively at three months. Conclusion: Lyme disease should be considered in the differential diagnosis of neuroretinitis, particularly in patients with a history of outdoor exposure and erythema migrans [1,2,4]. Early diagnosis and appropriate antibiotic therapy are essential to optimize visual prognosis [2,3].