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.