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Leber stellate neuroretinitis: two cases.

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Abstract

INTRODUCTION:

Described by Leber (1916), this clinical syndrome is characterized by unilateral decrease of visual acuity, papilledema and macular star. The condition concerns the young adult, has a favorable prognosis, and unspecified pathogeny.

OBSERVATIONS AND METHODS:

We report the case of two young adults (25 and 27 years), examined because of decreased visual acuity in the left eye, installed 2-3 weeks after a flu-like syndrome. Ophthalmoscopy reveals papilledema and macular star (lipid exudates). Fluorescein Angiography showed abnormal permeability at the optic disc, and the absence of vascular changes in the macular area. Campimetry, cranio-orbital imaging, and serological tests were carried out.

RESULTS:

Campimetry revealed a centrocecal unilateral scotoma. Serological tests for Bartonella hensellae,
Lyme disease, leptospirosis, and toxacara were negative. The cranio-orbital imaging was normal. Considering the syndrome to be idiopathic, no treatments have been performed; the visual acuity and papilledema resolved after 4 and respectively 6 weeks, and the macular exudates after 8 and respectively 12 months.

DISCUSSIONS, CONCLUSIONS:

The optic disc edema, with or without macular star, unsuitable called Leber’s stellate neuroretinitis, forms a group of diseases with heterogenous clinical aspect, and unspecified pathogenesis. Overall, it is necessary to remember that it is a diagnosis of exclusion, targeting infectious pathology in children, and a vascular or demyelinating process in adult patients. The favorable prognosis is making the cortisone therapy unnecessary in idiopathic forms, but requires a specific therapy in infectious forms.

Oftalmologia. 2011;55(4):66-9. Case Reports; English Abstract

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