Case Series of Neuroretinitis in Cat Scratch Disease

ABSTRACT

@#Introduction: Neuroretinitis is a typical ocular presentation of cat scratch disease (CSD). It is characterised by optic disc swelling with macular star formation. Bartonella henselae is the commonest cause of neuroretinitis. Case series This article provides a retrospective review of the variations in three patients’ clinical presentations and responses to the two of the treatment options available for the disease. We report a retrospective case series of neuroretinitis in CSD with three patients who presented to the ophthalmology clinic at Selayang Hospital from June 2016 to August 2019. All patients had a history of contact with cats with two of them had a history of fever before developing ocular symptoms. All patients presented with optic disc swelling and macular star. In addition, Case 2 presented with mild vitritis and Case 3 with multiple foci of choroiditis. A serology analysis of Bartonella henselae was positive for both immunoglobulin (Ig) M and IgG in all three patients. Two of the patients were treated with oral doxycycline, while Case 3 was treated with oral sulfamethoxazole and trimethoprim. All patients had a poor vision at their initial presentation, but none of them warranted oral prednisolone and had good visual outcomes. Conclusion: Neuroretinitis is a typical ocular presentation of CSD. Diagnosis is confirmed via positive serologic testing for Bartonella henselae. Although neuroretinitis is self-limiting, various treatment options can hasten disease recovery with good visual outcomes.