Cat-scratch disease is associated with 2 ocular syndromes: (1) Parinaud oculoglandular syndrome, which consists of conjunctival inflammation with preauricular adenopathy, and (2) Leber stellate neuroretinitis, which includes macular star formation and optic nerve head swelling, often associated with a peripapillary serous macular detachment (Fig 11-21). Small, focal areas of retinitis or chorioretinitis occur frequently in patients with neuroretinitis. In rare cases, an optic nerve head angiomatous lesion can develop. Immunocompetent adults with cat-scratch disease are treated with doxycycline, 100 mg twice daily for 4–6 weeks. Oral erythromycin can be used in children. Prolonged treatment with doxycycline and rifampin can be used in immunocompromised adults or in patients with persistent infection.
Figure 11-21 Color fundus photograph of neuroretinitis shows optic nerve head swelling and a macular star formation resulting from cat-scratch disease (Bartonella henselae).
(Courtesy of George Alexandrakis, MD.)
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.