title: Retinal artery occlusion due to Bartonella henselae infection: a case series.
abstract: OBJECTIVE
  To report a case series of six patients suffering from branch retinal artery occlusion due to Bartonella henselae infection, in order to raise awareness to this etiology in the differential diagnosis of retinal artery occlusion.
  
  
  METHODS
  A retrospective case series of patients with branch retinal artery occlusion due to ocular cat scratch disease who presented at four tertiary medical centers in Israel, Turkey and Saudi Arabia between the years 2008-2014. Data retrieved from the medical records included demographic data, exposure, complaints, visual acuity, clinical findings and imaging, laboratory assessment, treatment, disease course and visual outcome.
  
  
  RESULTS
  The study group consisted of six patients who presented with branch retinal artery occlusion with or without neuroretinitis. One patient had multiple artery occlusions. Diagnosis of cat scratch disease was established based on positive serology and accompanying systemic symptoms, after ruling out other causes of retinal artery occlusion. Treatment included various regimens of antibiotics and systemic steroids. Visual outcome depended upon the obstructed artery.
  
  
  CONCLUSIONS
  Cat scratch disease may cause retinal artery occlusion in infected patients, leaving them with a permanent visual field defect. When retinal artery occlusion occurs as an early sign of the disease, prompt recognition may prevent further events. Thorough history and relevant tests may be of great value.
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Maya
authors.initials: M
authors.lastname: Eiger-Moscovich
authors.affiliation: Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel.
authors.forename: Radgonde
authors.initials: R
authors.lastname: Amer
authors.affiliation: Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Merih
authors.initials: M
authors.lastname: Oray
authors.affiliation: Wilmer Ophthalmological Institute, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.|Eye Center and Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia.
authors.forename: Khalid F
authors.initials: KF
authors.lastname: Tabbara
authors.affiliation: Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Tugal-Tutkun
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Kramer
mesh_terms: D000328:Adult; 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*; D002939:Ciprofloxacin / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D015356:Retinal Artery Occlusion / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007075:Immunoglobulin M; D002939:Ciprofloxacin; D004318:Doxycycline; D012293:Rifampin
keywords: Bartonella Henselae; branch retinal artery occlusion; cat-scratch disease; neuroretinitis