ABSTRACT
OBJECTIVE: Evaluate the etiology and the most frequent funduscopic alterations of the neuroretinitis. METHODS: We present the case of a woman 24 years old with a bilateral decrease of visual sharpness (AV), painless and progressive, the funduscopic examination of which reveals a bilateral optical disc edema, with no hemorrhages or exudates, retina edema of the posterior pole and phlebitic areas. The systematic study was normal except for the hemogram (18,000/mm(3) leucocytes with 79% neutrophils) and the positive serology next to a Chlamydia. We also present the case of a 64 years old woman with a decrease of AV at the right eye of one week duration. At the back of the eye a macular star can be seen, and papilla edema. A systematic study gave normal results and positive serology at Bartonella henselae. RESULTS: The illness produced by a cat scratch is the most common cause of neuroretinitis. The customary findings are a loss of AV, discromatopsia, afferent papillary defects and abnormality on the visual field. Other frequent findings at the back of the eye are hemorrhagic nerve fibers, cotton-like exudates, papilla edema, macular star and glassy inflammation. The roll of antibiotic therapy is questionable. Oral ciprofloxacine seems to give good results.
Subject(s)
Retinitis , Female , Humans , Middle Aged , Retinitis/diagnosis , Retinitis/drug therapy , Retinitis/microbiology , Young AdultABSTRACT
Objetivo: Describir la etiología y las alteraciones funduscópicas más frecuentes de las neurorretinitis.Métodos: Presentamos el caso de una mujer de 24años con disminución de la agudeza visual (AV)bilateral, indolora y progresiva cuyo examen funduscópicomostraba un edema de disco óptico bilateralsin hemorragias ni exudados, edema retinianoen polo posterior y zonas de flebitis. El estudio sistémicofue normal excepto el hemograma(18.000/mm3 leucocitos con 79% de neutrófilos) yla serología positiva frente a Chlamydia. Presentamostambién el caso de una mujer de 64 años deedad con disminución de la AV en el ojo derecho de1 semana evolución. En el fondo de ojo (FO) seaprecia una estrella macular y edema de papila.Resultó estudio sistémico normal y serología positivaa Bartonella henselae.Resultados: La enfermedad por arañazo de gato esla causa más común de neurorretinitis. Los hallazgoshabituales consisten en una pérdida de AV, discromatopsia,defecto pupilar aferente y anormalidadesen el campo visual. Otros hallazgos frecuentesen el FO son hemorragias en la capa de fibras nerviosas,exudados algodonosos, edema de papila,estrella macular e inflamación vítrea. El papel de laterapia antibiótica es cuestionable. Parece que elciprofloxacino oral tiene buenos resultados(AU)
Objective: Evaluate the etiology and the most frequentfunduscopic alterations of the neuroretinitis.Methods:We present the case of a woman 24 yearsold with a bilateral decrease of visual sharpness(AV), painless and progressive, the funduscopicexamination of which reveals a bilateral optical discedema, with no hemorrhages or exudates, retinaedema of the posterior pole and phlebitic areas. Thesystematic study was normal except for the hemogram(18,000/mm3 leucocytes with 79% neutrophils)and the positive serology next to a Chlamydia.We also present the case of a 64 years oldwoman with a decrease of AV at the right eye of oneweek duration. At the back of the eye a macular starcan be seen, and papilla edema. A systematic studygave normal results and positive serology at Bartonellahenselae.Results: The illness produced by a cat scratch is themost common cause of neuroretinitis. The customaryfindings are a loss of AV, discromatopsia,afferent papillary defects and abnormality on thevisual field. Other frequent findings at the back ofthe eye are hemorrhagic nerve fibers, cotton-likeexudates, papilla edema, macular star and glassyinflammation. The roll of antibiotic therapy is questionable.Oral ciprofloxacine seems to give goodresults(AU)
