title: SOLITARY IDIOPATHIC CHOROIDITIS IN THE SETTING OF EXTENSIVE ANIMAL EXPOSURE.
abstract: OBJECTIVE
  To describe solitary idiopathic choroiditis in the setting of extensive animal exposure.
  
  
  METHODS
  A 56-year-old asymptomatic female equestrian with an extensive history of exposure to horses and dogs and a trapper of wild animals and rodents was discovered to have an amelanotic choroidal mass in the macular region and referred for suspicious atypical nevus.
  
  
  RESULTS
  Funduscopy revealed a deep yellow mass with overlying retinal pigment epithelial thinning and without visible subretinal fluid or lipofuscin. Mild hyperautofluorescence represented unmasking of scleral autofluorescence. Ultrasonography showed a 1.8-mm-thick echodense lesion. Enhanced depth imaging-optical coherence tomography disclosed a dense, elevated scleral mass with "volcanic" configuration, demonstrating choroidal compression and trace overlying subretinal fluid. These features were consistent with solitary idiopathic choroiditis/scleritis. Systemic evaluation for standard cat-related bartonellosis, tuberculosis, sarcoidosis, and syphilis were negative. Horse-, dog-, and rodent-related bartonellosis testing was not available. Observation was advised, and the findings remained stable at 6 months.
  
  
  CONCLUSIONS
  Solitary idiopathic choroiditis is best imaged on enhanced depth imaging-optical coherence tomography as a scleral lesion with "volcanic" configuration and often secondary to previous Bartonella infection. Serologic positivity for cat-related Bartonella decays over time, and testing for horse-, dog-, or rodent-related Bartonella is not commonly used.
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Vivek
authors.initials: V
authors.lastname: Kumar
authors.forename: Chloe T L
authors.initials: CT
authors.lastname: Khoo
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
mesh_terms: D000382:Agricultural Workers' Diseases / Q000175:diagnosis*; D000818:Animals; D001474:Bartonella Infections / Q000150:complications*; D002833:Choroiditis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D004285:Dogs; D005260:Female; D006736:Horses; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging