[Neuroretinitis in children--independent observations].
BACKGROUND
Neuroretinitis in children is a rarely occurring entity that is characterized by optic disk edema, macular hard exudates, peripapillary subretinal exudates and the presence of posterior vitreous cells. Neuroretinitis' etiology can be infectious or non-infectious. The non-infectious causes include: systemic diseases, vascular diseases, diabetes, cancer. Most cases of neuroretinitis are idiopathic. Other forms can have an infectious cause: from animal, bacterial, viral, fungal. It occurs usually as a benign complication of pediatric infectious diseases, cat scratch disease (bartonellosis), tuberculosis. Relaminar vasculitis is responsible for the clinical picture of neuroretinitis as opposed to the primary demyelination seen in optic neuritis. Exudate from the optic nerve head resulted from leakage of the disc capillaries that had extended into the macular area along the plane of the outer plexiform layer.


METHODS
The examination of 5 girls aged 8-12, hospitalized in the Ophthalmology Clinic of The Children's Memorial Health Institute in Warsaw in 2006-2007 revealed the intrabulbar neuroretinitis-type changes. Each patient was interviewed in detail and underwent full ophthalmologic examination.


RESULTS
All patients suffered from the loss of vision, 2 of them had ocular pain when looking at the sides. There was a marked afferent pupillary defect and the changes in the visual field were also reported. Fluorescein angiogram showed leakage of disk vessels; there was no leakage of other retinal vessels. In case of each girl, a vast differential diagnostics of infectious and systemic diseases was applied.


CONCLUSIONS
Despite significant diagnostic difficulties in this age group, 2 girls were recognized with non-pulmonary tuberculosis as the cause of neuroretinitis. The application of tuberculosis treatment significantly improved recovery.
Klinika Okulistyki Instytutu Pomnik-Centrum Zdrowia Dziecka w Warszawie al. Dzieci Polskich 20, 04-730 Warszawa.
Barbara
B
Chipczyńiska
Mirosława
M
Grałek
Beata
B
Kepa
D000995:Antitubercular Agents / Q000627:therapeutic use; D002372:Cat-Scratch Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D010211:Papilledema / Q000175:diagnosis / Q000209:etiology; D012173:Retinitis / Q000175:diagnosis* / Q000382:microbiology*; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
D000995:Antitubercular Agents