The clinical profile of idiopathic and cat scratch neuroretinitis: who is at risk for recurrence?

Details

Serval ID
serval:BIB_75866E5A172B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The clinical profile of idiopathic and cat scratch neuroretinitis: who is at risk for recurrence?
Journal
Neuro-Ophthalmology
Author(s)
Sundaram S.V., Purvin V.A., Kawasaki A.
ISSN
0165-8107; ISSN: 0165-8107 (print,1744-506X)
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
36
Number
3
Pages
85-92
Language
english
Abstract
Background: Most cases of neuroretinitis (NR) are idiopathic or due to cat scratch disease and occur as a single episode but a subgroup of patients experience recurrent attacks with cumulative visual loss. We reviewed our cases of NR to better characterize the clinical features of these subgroups in an effort to predict the risk of recurrence.
Methods: Retrospective study of NR patients from a single institution. Sixty-seven patients were divided into three groups: 22 cases due to cat scratch disease (CSD-NR), 24 with idiopathic neuroretinitis (I-NR) and 21 (23 eyes) with recurrent neuroretinitis (R-NR).
Results: Preceding systemic symptoms, predominantly central visual field (VF) loss and the combination of poor acuity with small relative afferent pupillary defect at presentation were common features of CSD-NR.
There were no cases of recurrent CSD-NR. In the first attack of R-NR, the magnitude of VF loss at presentation was greater compared to the other two groups. While 39% of R-NR had a pattern of VF loss other than a central or cecocentral scotoma, only 13.6% of CSD-NR and 17% of I-NR showed this pattern. Visual recovery was least substantial for the R-NR group (average gain of 3.7 lines of Snellen acuity vs. 5 and 6.4 lines for CSD-NR and I-NR, respectively, and an average gain in VF score of 5.1 in the R-NR group compared to 8.2 and 11.5 for the other two groups).
Conclusion: The main predictive factors for recurrence are absence of systemic symptoms, significant VF loss at presentation, particularly loss outside the central 30°, and less substantial visual recovery.
Keywords
Cat scratch disease, Macular star, Neuroretinitis, Optic nerve, Papillitis
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Create date
22/01/2013 15:17
Last modification date
20/08/2019 14:32
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