ESCRS - FP20.04 - Three Neonates Presenting With Congenital Cataract And Uveitis In 2 Years Caused By Spiroplasma Infection

Three Neonates Presenting With Congenital Cataract And Uveitis In 2 Years Caused By Spiroplasma Infection

Published 2025 - 43rd Congress of the ESCRS

Reference: FP20.04 | Type: Free paper | DOI: 10.82333/ezmz-gn97

Authors: R Prakhya* 1 , SRI GANESH 1 , SUPRIYA SRIGANESH 1 , SAVIO PEREIRA 1

1PHACOREFRACTIVE,NETHRADHAMA SUPERSPECIALITY EYE HOSPITAL,BANGALORE,India

Purpose

To demonstrate the importance of considering Spiroplasma infection as a cause of congenital cataract and inflammation in neonates 

Setting

Tertiary referral center, Amsterdam University Medical Centers, the Netherlands

Methods

Retrospective case series of neonates presenting from March 2023 to February 2025 with cataract and signs of uveitis followed by cataract extraction and aspiration of lens material in which high load of bacterial DNA was detected with IS-PRO and Spiroplasma was confirmed by 16 S RNA PCR. Cases were evaluated by pediatrician for further organ involvement. 
 

Results

Three neonates referred due to poor red reflex and small non-reactive pupil presented with cataract and anterior segment inflammation in one or both eyes with posterior synechiae, cyclic membrane, uveitic nodules or keratic precipitates. Two patients had macular scarring in the otherwise unaffected eye. Four eyes underwent cataract operation, posterior capsulotomy and anterior vitrectomy and left aphakic. All children were treated with systemic azithromycine. Visual axis opacification (VAO) and glaucoma required surgery in one eye of the first baby requiring surgery. One eye of the second baby had beginning VAO which resolved upon increasing topical steroids.

Conclusions

This case-series represent the first identified Spiroplasma infections in neonates in the Netherlands causing uni- or bilateral congenital cataract in combination with signs of uveitis. Two out of three patients had macular scarring which our center is the first to report to this date. Little is known of the incidence, mechanism of infection, systemic and developmental effects on these children. Spiroplasma is likely an underrecognized entity as diagnosing requires 16S RNA PCR on lens material. The incidence of three neonates in 2 years warrants urgent need for further research and awareness.