title: Clinical characteristics in 53 patients with cat scratch optic neuropathy.
abstract: OBJECTIVE
  To describe the clinical manifestations and to identify risk factors associated with visual outcome in a large cohort of patients with cat scratch optic neuropathy (CSON).
  
  
  METHODS
  Multicenter, retrospective chart review.
  
  
  METHODS
  Fifty-three patients (62 eyes) with serologically positive CSON from 5 academic neuro-ophthalmology services evaluated over an 11-year period.
  
  
  METHODS
  Institutional review board/ethics committee approval was obtained. Data from medical record charts were collected to detail the clinical manifestations and to analyze visual outcome metrics. Generalized estimating equations and logistic regression analysis were used in the statistical analysis. Six patients (9 eyes) were excluded from visual outcome statistical analysis because of a lack of follow-up.
  
  
  METHODS
  Demographic information, symptoms at presentation, clinical characteristics, length of follow-up, treatment used, and visual acuity (at presentation and final follow-up).
  
  
  RESULTS
  Mean patient age was 27.8 years (range, 8-65 years). Mean follow-up time was 170.8 days (range, 1-1482 days). Simultaneous bilateral involvement occurred in 9 (17%) of 53 patients. Visual acuity on presentation ranged from 20/20 to counting fingers (mean, 20/160). Sixty-eight percent of eyes retained a visual acuity of 20/40 or better at final follow-up (defined as favorable visual outcome). Sixty-seven percent of patients endorsed a history of cat or kitten scratch. Neuroretinitis (macular star) developed in 28 eyes (45%). Only 5 patients had significant visual complications (branch retinal artery occlusion, macular hole, and corneal decompensation). Neither patient age nor any other factor except good initial visual acuity and absence of systemic symptoms was associated with a favorable visual outcome. There was no association between visual acuity at final follow-up and systemic antibiotic or steroid use.
  
  
  CONCLUSIONS
  Patients with CSON have a good overall visual prognosis. Good visual acuity at presentation was associated with a favorable visual outcome. The absence of a macular star does not exclude the possibility of CSON.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Ophthalmology, Duke Eye Center and Duke University Medical Center, Durham, North Carolina 27710-3802, USA.
authors.forename: Sulene L
authors.initials: SL
authors.lastname: Chi
authors.forename: Sandra
authors.initials: S
authors.lastname: Stinnett
authors.forename: Eric
authors.initials: E
authors.lastname: Eggenberger
authors.forename: Rod
authors.initials: R
authors.lastname: Foroozan
authors.forename: Karl
authors.initials: K
authors.lastname: Golnik
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.forename: M Tariq
authors.initials: MT
authors.lastname: Bhatti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D018416:Bartonella henselae / Q000276:immunology / Q000302:isolation & purification; D002372:Cat-Scratch Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011379:Prognosis; D012173:Retinitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D014786:Vision Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D005938:Glucocorticoids