DOI: https://doi.org/10.36347/sjmcr.2026.v14i03.042

Pages: 491-495

Background: Lyme disease is a multisystem infectious disease caused by the spirochete Borrelia burgdorferi and transmitted by Ixodes ticks. Ocular involvement is uncommon but may affect several ocular structures including the retina, choroid, and optic nerve. We report a case of bilateral multifocal chorioretinitis with juxtafoveal serous retinal detachment associated with Lyme borreliosis documented using multimodal imaging. Case presentation: A 33‑year‑old woman presented with progressive painless visual decline in both eyes three months after a stay in a mountainous endemic area. Best corrected visual acuity was 8/10 in both eyes. Fundus examination revealed multiple yellow‑white punctiform lesions scattered in the posterior pole and mid‑peripheral retina, predominantly in the superior quadrants. Macular optical coherence tomography (OCT) demonstrated bilateral juxtafoveal serous retinal detachments associated with hyperreflective subretinal deposits and retinal pigment epithelium irregularities. Infectious work‑up excluded viral and syphilitic etiologies, while Lyme serology was positive. Cutaneous erythematous papular lesions on the lower limb supported systemic Lyme disease. The patient was treated with oral doxycycline for three weeks with complete visual recovery. Conclusion: Lyme borreliosis should be considered in the differential diagnosis of multifocal chorioretinitis associated with serous macular detachment, particularly in patients with exposure in endemic areas. Multimodal retinal imaging, especially OCT, plays a key role in identifying inflammatory macular changes and monitoring therapeutic response.