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Neuroretinitis in ocular bartonellosis: a case series.

Raihan AR, Zunaina E, Wan-Hazabbah WH, Adil H, Lakana-Kumar T - Clin Ophthalmol (2014)

Bottom Line: Serology analysis showed strongly positive for B. henselae in all of the patients.All patients showed a good visual outcome except case 3.Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

ABSTRACT
We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline), and two patients (case 1 and case 3) had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.

No MeSH data available.


Related in: MedlinePlus

Fundus and OCT findings at presentation and follow-up for right eye in case 3.Notes: Right eye showed optic disc swelling with focal retinitis and macular edema with retinal exudates at presentation (A). OCT showed presence of subretinal fluid at presentation (B). There was formation of macular star at 1-week follow-up (C), and resolution of optic disc swelling and macular edema at 6-week follow-up (D). Repeat OCT showed resolution of subretinal fluid at 6-week follow-up (E).Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; max, maximum; min, minimum; OCT, optical coherence tomography; vol, volume.
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f4-opth-8-1459: Fundus and OCT findings at presentation and follow-up for right eye in case 3.Notes: Right eye showed optic disc swelling with focal retinitis and macular edema with retinal exudates at presentation (A). OCT showed presence of subretinal fluid at presentation (B). There was formation of macular star at 1-week follow-up (C), and resolution of optic disc swelling and macular edema at 6-week follow-up (D). Repeat OCT showed resolution of subretinal fluid at 6-week follow-up (E).Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; max, maximum; min, minimum; OCT, optical coherence tomography; vol, volume.

Mentions: Physical examination revealed a body temperature of 37.0°C and presence of right submandibular lymphadenopathy. BCVA was counting fingers in the right eye and 6/7.5 in the left eye. There was absence of RAPD. Fundus examination of the right eye showed optic disc swelling associated with flame-shaped retinal hemorrhages. There was presence of focal retinitis lesion at the temporal and superior margins of the optic disc (Figure 4A). The optic disc swelling was associated with macular edema with retinal exudates. Ocular examination of the left eye was normal. OCT of the right eye showed presence of subretinal fluid (Figure 4B).


Neuroretinitis in ocular bartonellosis: a case series.

Raihan AR, Zunaina E, Wan-Hazabbah WH, Adil H, Lakana-Kumar T - Clin Ophthalmol (2014)

Fundus and OCT findings at presentation and follow-up for right eye in case 3.Notes: Right eye showed optic disc swelling with focal retinitis and macular edema with retinal exudates at presentation (A). OCT showed presence of subretinal fluid at presentation (B). There was formation of macular star at 1-week follow-up (C), and resolution of optic disc swelling and macular edema at 6-week follow-up (D). Repeat OCT showed resolution of subretinal fluid at 6-week follow-up (E).Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; max, maximum; min, minimum; OCT, optical coherence tomography; vol, volume.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4128839&req=5

f4-opth-8-1459: Fundus and OCT findings at presentation and follow-up for right eye in case 3.Notes: Right eye showed optic disc swelling with focal retinitis and macular edema with retinal exudates at presentation (A). OCT showed presence of subretinal fluid at presentation (B). There was formation of macular star at 1-week follow-up (C), and resolution of optic disc swelling and macular edema at 6-week follow-up (D). Repeat OCT showed resolution of subretinal fluid at 6-week follow-up (E).Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; max, maximum; min, minimum; OCT, optical coherence tomography; vol, volume.
Mentions: Physical examination revealed a body temperature of 37.0°C and presence of right submandibular lymphadenopathy. BCVA was counting fingers in the right eye and 6/7.5 in the left eye. There was absence of RAPD. Fundus examination of the right eye showed optic disc swelling associated with flame-shaped retinal hemorrhages. There was presence of focal retinitis lesion at the temporal and superior margins of the optic disc (Figure 4A). The optic disc swelling was associated with macular edema with retinal exudates. Ocular examination of the left eye was normal. OCT of the right eye showed presence of subretinal fluid (Figure 4B).

Bottom Line: Serology analysis showed strongly positive for B. henselae in all of the patients.All patients showed a good visual outcome except case 3.Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

ABSTRACT
We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline), and two patients (case 1 and case 3) had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.

No MeSH data available.


Related in: MedlinePlus