Optic Neuritis Associated with Lyme Disease

I tested 20 consecutive newly diagnosed patients with isolated optic neuritis for serology against Borrelia burgdorferi. All resided in a region endemic for Lyme disease. Four (20%) patients had positive serology. One patient refused to undergo lumbar puncture, and another had normal cerebrospinal fluid (CSF) findings. The other two patients had CSF pleocytosis with negative evaluations for other infections, rheumatologic disorders, and malignancy