Macular findings on optical coherence tomography in cat-scratch disease neuroretinitis

• Published in: Eye (London) 2011-08, Vol.25 (8), p.1064-1068
• Main Authors: Habot-Wilner, Z, Zur, D, Goldstein, M, Goldenberg, D, Shulman, S, Kesler, A, Giladi, M, Neudorfer, M
• Format: Article
• Language: English
• Subjects: 692/1807/1482; 692/700/1421/1846; Adolescent; Adult; Age; Angiography; Bacterial diseases; Bartonellosis; Biological and medical sciences; Cat-Scratch Disease - pathology; Cat-Scratch Disease - physiopathology; Child; Clinical Study; Edema; Exudates; Eye; Female; fluorescein; Fluorescein Angiography; Human bacterial diseases; Humans; Infectious diseases; Laboratory Medicine; Macular Edema - pathology; Macular Edema - physiopathology; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous; Ophthalmology; Optic nerve; Pharmaceutical Sciences/Technology; Retina; Retinitis; Retinitis - pathology; Retinitis - physiopathology; Retinopathies; Retrospective Studies; Sensitivity and Specificity; Surgery; Surgical Oncology; Tomography; Tomography, Optical Coherence - standards; Tropical bacterial diseases; Visual Acuity - physiology; Young Adult
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2011.125

Purpose To describe the macular findings on optical coherence tomography (OCT) in patients with cat-scratch disease (CSD) neuroretinitis. Methods Medical records of all patients diagnosed with CSD neuroretinitis at the Tel Aviv Medical Center between April 2006 and May 2010 were retrospectively reviewed. All patients underwent Stratus OCT macular examination. Results Eight eyes of seven patients with confirmed CSD neuroretinitis, (mean age 33±9.9 years, range 6–48 years) were included in the study. All patients presented clinically with optic nerve swelling and macular edema or macular exudates. OCT demonstrated flattening of the foveal contour, thickening of the neurosensory retina, and accumulation of subretinal fluid (SRF) in all studied eyes. Retinal exudates appeared as multiple hyper-reflective foci in the outer plexiform layer. The average central macular thickness was 460  μ m (range 170–906  μ m) and the average maximal retinal thickness was 613  μ m (range 387–1103  μ m), at presentation. The macula appeared normal on repeated exams during follow-up. Conclusion Similar OCT findings were demonstrated in patients with CSD neuroretinitis. SRF was found in all eyes, although was not visible on clinical examination or fluorescein angiography. OCT may be used as an adjunct imaging tool in the diagnosis and follow-up of patients with CSD neuroretinitis.