Ocular Manifestations of Brucellosis

Brucellosis is considered a zoonotic disease which is still an important health problem in endemic areas such as the Middle East, the Mediterranean, and Asia. Brucellosis is a sys‐ temic infection that might affect any organ or system in the body. Ocular involvement has been reported in 21% of brucellosis patients. The most common ocular manifestations of brucellosis were considered as anterior uveitis and choroiditis. The patients with ante‐ rior uveitis were reported to be usually in the acute stage and the patients with choroidi‐ tis, papilledema, and posterior uveitis were reported to be usually in the chronic stage of the disease. Ocular manifestations of brucellosis might also involve dacryoadenitis, con‐ junctivitis, episcleritis, scleritis, nummular keratitis, cataract, glaucoma, exudative retinal detachment, maculopathy, and neuro-ophthalmic defects including papilledema, papilli‐ tis, and cranial nerve paresis. Optic nerve involvement in brucellosis is considered secon‐ dary to meningeal inflammation, and it usually involves both optic nerves. Premacular hemorrhage related to Brucella endocarditis was reported as a rare ocular manifestation. Since ocular brucellosis has a wide spectrum of clinical manifestations, the diagnosis is considered to be mainly dependent on positive bacteriological and serological tests. Ag‐ glutinations and/or culture has been widely used for diagnosis of brucellosis. Brucella ag‐ glutination test over 1/160 titer and positive blood culture are considered as diagnostic factors for brucellosis. Early diagnosis and prompt treatment are considered to be effec‐ tive for preventing blindness from severe ocular damage. Systemic antibiotics including streptomycine, rifampicin, doxycycline along with topical or systemic corticosteroid treatment have been recommended for at least 2 months. The purpose of this chapter is to describe the ocular manifestations of brucellosis, early diagnostic procedures, and treat‐ ment with reviewing the literature.