Diverse Clinical Signs of Ocular Involvement in Cat Scratch Disease.
OBJECTIVE
To describe ocular manifestations, diagnosis, and treatment of cat scratch disease.


METHODS
Clinical records of patients with ocular cat scratch disease were reviewed.


RESULTS
Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9±18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms. Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, ≤0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients. Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47±14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye.


CONCLUSIONS
Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations.
İstanbul University İstanbul Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.
Merih
M
Oray
Koç University Faculty of Medicine, Department of Ophthalmology; VKV American Hospital, Ophthalmology Clinic, İstanbul, Turkey.
Sumru
S
Önal
Koç University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.
Aylin
A
Koç Akbay
İstanbul University İstanbul Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.
İlknur
İ
Tuğal Tutkun
Cat scratch disease; endophthalmitis; neuroretinitis; optic neuropathy; retinal infiltrate