Journal francais d'ophtalmologie · 2025
Epidemiological and clinical profiles of ocular involvement in rickettsiosis in southern Tunisia.
СтатьяНазвание и аннотация: Перевод в очереди
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Kaibi I, Maalej Y, Sehli M, Abid A, Gargouri S, Trigui A
Аннотация
INTRODUCTION: The ocular manifestations of rickettsial diseases are polymorphic. The goal of our work was to characterize the ocular manifestations of rickettsial diseases and to determine the contribution of ophthalmic examination to the diagnosis.
METHODS: We conducted a retrospective descriptive analysis including consecutive patients with ocular involvement from confirmed rickettsial disease after ruling out other infectious or inflammatory etiologies. Demographic, clinical, multimodal imaging (fluorescein angiography, optical coherence tomography [OCT]), and therapeutic intervention data were systematically analyzed.
RESULTS: This study included 24 patients with serologically confirmed rickettsial ocular involvement (mean age 40 years; range 16-67). Presentation with ophthalmologic symptoms occurred in 54.2% (n=13), demonstrating unilateral (58.4%, n=14) or bilateral (41.7%, n=10) ocular involvement, totaling 34 affected eyes. Posterior uveitis predominated (70.5%, 24 eyes), while other significant ophthalmologic signs included fine keratic precipitates (17.6%, 6 eyes), retinitis (64.7%, 22 eyes), retinal vasculitis (20.6%, 7 eyes), and neuroretinitis (8.8%, 3 eyes). Systemic manifestations featured febrile episodes with cutaneous eruptions in 70.8% (n=17). All patients received antibiotic treatment. Oral corticosteroid therapy was added in 12.5% (n=3). Complete resolution of inflammation occurred after a mean follow-up of 3 months.
CONCLUSION: In our series, ocular manifestations in rickettsial infections presented symptomatically in only half of cases, with retinitis and retinal vasculitis emerging as the predominant findings. These observations highlight the importance of systematic posterior segment examination in suspected rickettsial cases to facilitate prompt diagnosis and therapeutic intervention.
METHODS: We conducted a retrospective descriptive analysis including consecutive patients with ocular involvement from confirmed rickettsial disease after ruling out other infectious or inflammatory etiologies. Demographic, clinical, multimodal imaging (fluorescein angiography, optical coherence tomography [OCT]), and therapeutic intervention data were systematically analyzed.
RESULTS: This study included 24 patients with serologically confirmed rickettsial ocular involvement (mean age 40 years; range 16-67). Presentation with ophthalmologic symptoms occurred in 54.2% (n=13), demonstrating unilateral (58.4%, n=14) or bilateral (41.7%, n=10) ocular involvement, totaling 34 affected eyes. Posterior uveitis predominated (70.5%, 24 eyes), while other significant ophthalmologic signs included fine keratic precipitates (17.6%, 6 eyes), retinitis (64.7%, 22 eyes), retinal vasculitis (20.6%, 7 eyes), and neuroretinitis (8.8%, 3 eyes). Systemic manifestations featured febrile episodes with cutaneous eruptions in 70.8% (n=17). All patients received antibiotic treatment. Oral corticosteroid therapy was added in 12.5% (n=3). Complete resolution of inflammation occurred after a mean follow-up of 3 months.
CONCLUSION: In our series, ocular manifestations in rickettsial infections presented symptomatically in only half of cases, with retinitis and retinal vasculitis emerging as the predominant findings. These observations highlight the importance of systematic posterior segment examination in suspected rickettsial cases to facilitate prompt diagnosis and therapeutic intervention.