Spontaneous cataract absorption in patients with leptospiral uveitis

Abstract

Aims-To describe the occurrence of spontaneous cataract absorption in patients with leptospiral uveitis. Methods-The records of patients with seropositive leptospiral uveitis seen in the uveitis clinic at Aravind Eye Hospital between January 1994 and December 1997 were reviewed retrospectively. Results-During the 4 years of the study, 394 eyes of 276 patients with seropositive leptospiral uveitis were identified. Of these, 54 eyes (13.7%) of 41 patients (14.9%) had a final visual acuity of 20/40 or worse attributable to cataract formation. Of these 54 eyes, 41 eyes (75.9%) had visually significant cataract on their first visit to the uveitis clinic, and 13 eyes (24.1%) were noted to have cataract 1-6 months after presentation. Spontaneous absorption was observed in 10 eyes (18.5%) of eight patients (19.5%), and occurred from 6 weeks to 18 months, with a median of 5 months, after the onset of cataract. Of 12 035 consecutive, non-leptospiral, nontraumatic, uveitic, control patients seen during the same 4 years of the study, none showed spontaneous cataract absorption. Conclusion-Spontaneous cataract absorption occurs in a significant number of patients with leptospiral uveitis, and appears to be unique to this form of non-traumatic uveitis.

A case of bilateral, spontaneous absorption of lenses

“…Spontaneous lens absorpsyndrome 8 and Down syndrome. 9 Spontaneous lens absorption in patients diagnosed with leptospirosis was reported by Rathinam et al 2 A case of phacolytic glaucoma followed by spontaneous lens absorption was also reported by Blaise et al 10 The exact mechanism of lens absorption is unclear and likely varies according to the cause. In leptospirosis, it is not clear whether leptospires themselves or antibodies directed against them have a role in cataract causation and absorption.…”

“…In leptospirosis, it is not clear whether leptospires themselves or antibodies directed against them have a role in cataract causation and absorption. 2 Likewise, rubella virus has been isolated from clear lens material of infants with congenital rubella syndrome as well as from cataractous lens material even at 35 months of age. 6 Injury to the lens capsule might be responsible for spontaneous lens absorption seen in traumatic cases.…”

LruA and LruB Antibodies in Sera of Humans with Leptospiral Uveitis

“…Cataract is a common complication of uveitis in human and equine patients but usually remains stable after initial inflammation is controlled. Spontaneous absorption of cataract, though seen mainly in traumatic cataract, congenital rubella, and age-related leaking Morganian cataract (3,16), has also been reported in a small number of leptospiral uveitis patients (22).…”

“…is the most common cause of equine recurrent uveitis (12,13), which is characterized by an initial uveitic episode followed weeks to months later by regularly recurring episodes of intraocular inflammation (10). Human leptospiral uveitis has been reported in various areas of the world, including the region around the city of Madurai in southern India (6,17,22,23). The prolonged symptom-free period between leptospiral infection and clinical onset of an ocular condition, the clinical/ morphological similarity of different uveitic entities, and the protean manifestations of leptospiral uveitis all make a definitive diagnosis difficult for the ophthalmologist.…”

The incidence and clinical characteristics of the immune phase eye disease in treated cases of human leptospirosis

“…[6] Uveitis is an important late complication of leptospirosis and may present as anterior or posterior uveitis or as panuveitis. [8][9][10][11][12][13][14] The other manifestations described [9][10][11][12][13][14][15] are hypopyon, rapid maturation of cataract, absorption of cataract, glaucoma, vitreous inflammatory reaction, optic neuritis, retinal vasculitis, retinal hemorrhage, retinal detachment and neuroretinitis. Leptospirosis is a common cause of uveitis in south India and accounts for a signifi cant proportion of cases, which were previously labeled as idiopathic uveitis.…”