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Diverse Clinical Signs of Ocular Involvement in Cat Scratch Disease

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Abstract
 
OBJECTIVES:
To describe ocular manifestations, diagnosis, and treatment of cat scratch disease.
 
MATERIALS AND METHODS:
Clinical records of patients with ocular cat scratch disease were reviewed.
 
RESULTS:
Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9±18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms.
 
Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, ?0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients.
 
Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47±14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye.
 
CONCLUSION:
Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations.
 
Source: By y M1, Önal S2, Koç Akbay A3, Tugal Tutkun 1. Diverse Clinical Signs of Ocular Involvement in Cat Scratch Disease. Turk J Ophthalmol. 2017 Jan;47(1):9-17. doi: 10.4274/tjo.28009. Epub 2017 Jan 17.

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