Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection.
OBJECTIVE
To describe optic disk edema associated with peripapillary serous retinal detachment as an early sign of systemic Bartonella henselae infection.


METHODS
Multicentered, retrospective case series.


RESULTS
Five women and two men presented with optic disk edema producing peripapillary serous retinal detachment. Each patient had a markedly elevated serum anti-B. henselae antibody titer. Patient age ranged from 11 to 44 years, with a mean and median of 26.6 and 28 years, respectively. The time from the onset of systemic symptoms to the onset of visual symptoms varied from 3 days to 1 month. The peripapillary serous retinal detachment resolved within 1 to 3 weeks in each case, producing a macular star in four of seven patients. Initial vision was 20/200 or worse in five of seven patients and improved in four of these five patients to 20/30 or better.


CONCLUSIONS
Systemic B. henselae infection should be considered in patients who develop optic disk edema associated with a peripapillary serous retinal detachment, even in the absence of classic neuroretinitis with a macular star.
Wade
N K
NK
Francis I. Proctor Foundation, University of California, San Francisco, CA 94143-0944, USA.
Levi
L
L
Jones
M R
MR
Bhisitkul
R
R
Fine
L
L
Cunningham
E T
ET
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000032:analysis; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D018416:Bartonella henselae / Q000276:immunology / Q000302:isolation & purification*; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D004318:Doxycycline / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D010211:Papilledema / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D012163:Retinal Detachment / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D012189:Retrospective Studies; D014792:Visual Acuity
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D004318:Doxycycline