NEOVASCULAR GLAUCOMA AS PRESENTING FEATURE OF OCULAR LEPTOSPIROSIS – A CASE REPORT
Background: Leptospirosis is a waterborne zoonosis, commonly found in tropical countries with heavy rainfall. Leptospirosis poses a diagnostic challenge due to its diverse clinical features that range from prodromal symptoms to multiorgan failure. Most cases of leptospirosis are under diagnosed due to its biphasic nature of presentation. We report a rare case of ocular leptospirosis presenting as unilateral neovascular glaucoma.
Materials and Methods: A case report.
Result: A 54-year-old gentleman who was previously well presented with right eye generalized progressive blurring of vision for one-month duration. One month later, he experienced right eye pain and redness. His right vision was of perception of light while the left vision was 6/6, with high intraocular pressure of 54 mmHg and positive relative afferent pupillary defect. A provisional diagnosis of right eye neovascular glaucoma secondary to panuveitis was made. Infective screening showed positive Anti-leptospiral immunoglobulin M (IgM). Oral Azithromycin was commenced for 6 weeks and oral prednisolone 1mg/kg was added after a week of oral antibiotics. On subsequent follow-up, his vision had gained to hand movement vision.
Conclusions: The awareness of the spectrum of these clinical manifestations may assist clinicians in making a timely diagnosis and instituting successful treatment. Understanding the specificity and sensitivity of enzyme–linked immunosorbent assay (ELISA) test in diagnosis of leptospirosis infection should be highlighted in handling cases with tropical fever or idiopathic panuveitis. Long-term follow-up is required to detect the late complications of leptospirosis. Azithromycin is another viable option for treatment of ocular leptospirosis.Keywords: Leptospirosis, ocular leptospirosis, neovascular glaucoma, panuveitis