title: Posterior segment involvement in cat-scratch disease: A case series.
abstract: BACKGROUND
  Cat-scratch disease (CSD) is a systemic infectious disease. The most well-known posterior segment presentation is neuroretinitis with a macular star. In this study, we present a case series emphasising the heterogeneity of the disease and the various posterior segment manifestations.
  
  
  METHODS
  A retrospective case series of consecutive patients presenting with posterior segment CSD, over a 5-year period (2010 to 2015), at two ophthalmological centres in Midi-Pyrénées.
  
  
  RESULTS
  Twelve patients (17 eyes) were included, of whom 11 (92%) presented with rapidly decreasing visual acuity, with 6 of these (50%) extremely abrupt. CSD was bilateral in 5 (42% of all patients). Posterior manifestations were: 12 instances of optic nerve edema (100%), 8 of focal chorioretinitis (67%) and only 6 of the classic macular edema with macular star (25% at first examination, but 50% later). Other ophthalmological complications developed in three patients; one developed acute anterior ischemic optic neuropathy, one a retrohyaloid hemorrhage and one a branch retinal artery occlusion, all secondary to occlusive focal vasculitis adjacent to focal chorioretinitis.
  
  
  CONCLUSIONS
  Classical neuroretinitis with macular star is not the only clinical presentation of CSD. Practitioners should screen for Bartonella henselae in all patients with papillitis or focal chorioretinitis.
authors.affiliation: Unité de rétine, consultation d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Tolou
authors.affiliation: Unité de rétine, consultation d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Mahieu
authors.affiliation: Service de maladies infectieuses et tropicales, CHU de Toulouse, 31059 Toulouse, France; Inserm U1043, CNRS UMR 5282, centre de physiopathologie de Toulouse-Purpan, 31059 Toulouse, France; Université Toulouse III, 31000 Toulouse, France.
authors.forename: G
authors.initials: G
authors.lastname: Martin-Blondel
authors.affiliation: Unité de rétine, consultation d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Ollé
authors.affiliation: Service d'ophtalmologie, hôpital de la Timone, université d'Aix-Marseille, AP-HM, 13385 Marseille, France; Centre d'ophtalmologie, clinique de l'Union, 31240 Saint-Jean, France.
authors.forename: F
authors.initials: F
authors.lastname: Matonti
authors.affiliation: Unité de rétine, consultation d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Hamid
authors.affiliation: Laboratoire GR2DE, EA4555, centre de physiopathologie de Toulouse-Purpan, 31059 Toulouse, France.
authors.forename: X
authors.initials: X
authors.lastname: Benouaich
authors.affiliation: Service de maladies infectieuses et tropicales, CHU de Toulouse, 31059 Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Debard
authors.affiliation: Unité de rétine, consultation d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France; Université Toulouse III, 31000 Toulouse, France; Laboratoire GR2DE, EA4555, centre de physiopathologie de Toulouse-Purpan, 31059 Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Cassagne
authors.affiliation: Unité de rétine, consultation d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France; Université Toulouse III, 31000 Toulouse, France; Laboratoire GR2DE, EA4555, centre de physiopathologie de Toulouse-Purpan, 31059 Toulouse, France. Electronic address: vincesoler@yahoo.fr.
authors.forename: V
authors.initials: V
authors.lastname: Soler
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002372:Cat-Scratch Disease / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D002415:Cats; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000209:etiology*; D057972:Posterior Eye Segment / Q000473:pathology*; D012173:Retinitis / Q000209:etiology*; D012189:Retrospective Studies; D012621:Seasons; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents
keywords: Bartonella henselae; Cat-scratch disease; Chorioretinitis; Choriorétinite; Infection oculaire; Maladie des griffes du chat; Neuroretinitis; Neurorétinite; Ocular infection; Oedème papillaire; Papilledema; Papillite; Papillitis; Posterior segment; Segment postérieur