Manifestations of Whipple's disease in the posterior segment of the eye
M. P. Avila, A. E. Jalkh, E. Feldman, C. L. Trempe and C. L. Schepens
Ocular manifestations of Whipple's disease result from CNS involvement,
direct intraocular involvement, or both. Ocular signs caused by CNS
involvement occurred in 30 of the 34 patients with ocular manifestations
described in the literature. In only four of the 34 cases were ocular
manifestations due solely to intraocular involvement. Two cases reported
herein had unique intraocular involvement, manifested as diffuse
chorioretinal inflammation. Fluorescein angiography showed diffuse
vasculitis, with hemorrhages, exudates, retinal capillary occlusion in the
perifoveal and midperipheral areas, capillary dilation at the optic disc,
and choroidal folds. Proper antibiotic treatment resulted in ocular and
systemic recovery. Follow-up is mandatory because of possible recurrences,
which may start with intraocular signs, followed by systemic
manifestations. Some cases progress to fetal CNS involvement. Therefore,
when intraocular signs recur in treated patients, antibiotic therapy should
be restarted or dose should be increased.
