RESUMEN
OBJECTIVE: To evaluate the posterior segment findings seen in ocular cat scratch disease. DESIGN: Retrospective case series. PARTICIPANTS: There were 24 patients (35 eyes) with choroidal, retinal, or optic disc manifestations of Bartonella infection evaluated at the authors' institutions over a 6-year period. MAIN OUTCOME MEASURES: Clinical and photographic records were reviewed for evidence of disc edema, macular star, foci of retinitis or choroiditis, choroidal masses, optic nerve masses, vascular-occlusive events, or other findings. RESULTS: Discrete white retinal or choroidal lesions, 50 to 3000 microm in diameter, were the most common posterior segment findings in this series of patients (83% of eyes, 83% of patients). Optic disc swelling was the second most common finding (46% of eyes, 63% of patients) followed by a macular star (43% of eyes, 63% of patients). Vascular-occlusive events were also seen (14% of eyes, 21% of patients), and the site of occlusion was found to be intimately associated with the aforementioned retinal lesions. Final visual acuity was 20/25 or better in 26 (74%) of 35 eyes and was similar in both treated and untreated patients. CONCLUSION: Isolated foci of retinitis or choroiditis were the most common ocular manifestation of cat scratch disease in the authors' patient population, but an array of posterior segment findings may occur.
Asunto(s)
Enfermedad por Rasguño de Gato/diagnóstico , Coroiditis/diagnóstico , Infecciones Bacterianas del Ojo/diagnóstico , Papiledema/diagnóstico , Retinitis/diagnóstico , Adolescente , Adulto , Antibacterianos/uso terapéutico , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Niño , Coroiditis/tratamiento farmacológico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Femenino , Fondo de Ojo , Humanos , Masculino , Persona de Mediana Edad , Papiledema/tratamiento farmacológico , Retinitis/tratamiento farmacológico , Estudios Retrospectivos , Trastornos de la Visión/diagnóstico , Agudeza VisualRESUMEN
Phototoxic retinal lesions are a product of advances in operative technology. Use of more powerful light sources in both anterior and posterior segment cases and an increase in surgical complexity requiring longer operative times (especially during ophthalmic training) have rendered photic injury a real danger for all surgeons. Though we enjoy the enhanced view offered by modern light sources, we must also keep in mind the additive, detrimental effect of prolonged light exposure. With increased awareness of this potential hazard, surgeons can take steps to minimize the chance of generating a sight-threatening phototoxic lesion.
