UVEITIS ASSOCIATED WITH AN EPIDEMIC OUTBREAK OF LEPTOSPIROSIS

PURPOSE: To define uveitis associated with leptospirosis in a clinical setting. METHODS: We present the clinical features of 73 consecutive cases of uveitis linked clinically to an outbreak of systemic leptospi rosis in patients with antibodies to Leptospira species who were exami ned from January to September 1994. RESULTS: In 73 patients, the patte rn of ocular involvement was unilateral in 35 and bilateral in 38. Pan uveitis was seen in 106 eyes (95.5%), retinal periphlebitis in 57 eyes (51.4%), and hypopyon in 14 eyes (12.6%). Anterior uveitis alone with out hypopyon was observed in three eyes (2.7%), whereas vitreous infla mmatory reaction alone was seen in two eyes (1.8%). Sixty of 73 patien ts (82.2%) or 91 of 111 eyes (82.0%) were followed up for 8 months. Fi nal visual acuity was 6/6 (20/20) in 47 eyes (52%) and improved during treatment, although not up to 6/6, in 15 eyes (16%). Twenty-eight eye s (31%) maintained same vision, and one eye showed deterioration of vi sion. CONCLUSION: Uveitis associated with leptospirosis may manifest a s unilateral of bilateral uveitis, anterior uveitis, or panuveitis. Th e prognosis is generally good in this entity, even when the inflammati on is severe. Awareness of this disease in endemic areas is important in order to differentiate it from other uveitic entities, especially i n young male patients in whom other immunologic uveitides are also com mon.