Branch retinal arterial occlusions in multifocal retinitis with optic nerve edema.
OBJECTIVE
To determine the natural history and visual prognosis of patients with branch retinal arterial occlusions secondary to multifocal retinitis.


METHODS
Cases were reviewed for seven patients who exhibited multifocal retinitis and branch retinal arterial occlusion. The average age of the patients was 27 years (age range, 14 to 19 years).


RESULTS
Six patients had systemic illnesses associated with their ocular findings. Four patients were scratched by a cat or exposed to a cat with fleas within 1 month of symptoms. Three of these patients were tested and had positive cat-scratch disease titers. At presentation, five patients complained of a scotoma, and two noted blurred vision. On examination, visual acuity was 20/25 or better in all but one eye. Five patients had vitritis, which was bilateral in three. Four patients exhibited optic nerve edema, which was bilateral in two. White intraretinal infiltrates were present in all patients, and were bilateral in five. The six patients who were examined within 1 week of symptoms had a white retinal infiltrate at the site of vascular occlusion. The retinal findings resolved in 2 to 6 weeks and did not recur. The final visual acuity was 20/20 OU in all patients.


CONCLUSIONS
Branch retinal arterial occlusions represent a complication of multifocal retinitis and idiopathic optic nerve edema. The arterial occlusions are probably caused by a focus of retinitis. This self-limited disorder has an excellent visual prognosis and may be related to cat-scratch disease.
Cohen
S M
SM
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami (Fla) School of Medicine, USA.
Davis
J L
JL
Gass
D M
DM
D000293:Adolescent; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002372:Cat-Scratch Disease / Q000188:drug therapy / Q000209:etiology; D002415:Cats; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005128:Eye Diseases / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D009898:Optic Disk / Q000473:pathology; D010211:Papilledema / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D015356:Retinal Artery Occlusion / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D012173:Retinitis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies; D012607:Scotoma / Q000188:drug therapy / Q000209:etiology; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology; D014947:Wounds and Injuries / Q000188:drug therapy / Q000209:etiology
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D011241:Prednisone