Cat-scratch disease associated with branch retinal artery occlusion.
OBJECTIVE
We describe two cases of branch retinal artery occlusion (BRAO) as the presenting sign of cat-scratch disease.


METHODS
Case 1 (25-year-old man) presented with decreased vision, visual field changes, a swollen disk, and BRAO. Case 2 (27-year-old woman) presented with decreased vision bilaterally: findings on examination were a macular star figure on the right eye and a BRAO on the left.


RESULTS
Both cases clinically improved after a course of systemic antibiotics. Case 1 had a normal optic disk and almost a complete resolution of the ischemic area 4 weeks after treatment. Case 2 had a complete resolution of the BRAO, and her macular exudates and optic disk edema partially resolved 5 weeks after treatment.


CONCLUSIONS
Cat-scratch disease should be considered in the differential diagnosis of BRAO, especially in young patients. The use of systemic antibiotics in cat scratch neuroretinitis, although proven beneficial in our patients, remains controversial and should probably be reserved for the more severe forms of the disease.
From the *Department of Ophthalmology, and †Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Michael
M
Waisbourd
Michaella
M
Goldstein
Michael
M
Giladi
Shiri
S
Shulman
Anat
A
Loewenstein