# Multicenter Retrospective Study of Spiroplasma ixodetis Infantile Cataract in 8 Countries in Europe

## TL;DR

This study identifies Spiroplasma ixodetis as a rare cause of infantile cataract and uveitis across Europe, suggesting its inclusion in diagnostic criteria.

## Contribution

The study provides multicenter evidence linking S. ixodetis to infantile cataract and uveitis, advocating for its inclusion in TORCH screening.

## Key findings

- 28 eyes from 18 infants across 8 European countries showed cataracts and uveitis linked to S. ixodetis.
- PCR, electron microscopy, and culture confirmed S. ixodetis presence in most cases.
- Treatment with macrolides, steroids, and lensectomy was effective, though some cases recurred.

## Abstract

Spiroplasma ixodetis has been reported to cause the rare combination of cataract and uveitis in infants. Through a retrospective analysis of available literature and additional unpublished cases, we identified 28 eyes from 18 infants from 8 countries in Europe with cataracts and intraocular inflammation. The cataracts were bilateral in 55.6%, unilateral in 44.4%, and progressive in 46.4% of patients. Granulomatous anterior uveitis was found in all infants. Presence of S. ixodetis was supported by PCR (positive in 89.3% of eyes tested), transmission electron microscopy (positive in 90% of eyes tested), or culture of aspirated lens material (positive in 87.5% of eyes tested). Treatment with macrolide antimicrobial drugs, corticosteroids, and lensectomy appeared to be effective. Two patients had a recurrence of the uveitis after lens extraction and needed prolonged treatment. To increase awareness of S. ixodetis, we suggest its inclusion with the organisms of the TORCH acronym.