A patient with cat scratch disease may develop an optic neuropathy.
Patient selection: infection with Bartonella henselae
Presentation:
(1) reduced visual acuity in one or both eyes
(2) history of a cat or kitten scratch
(3) positive serology for Bartonella henselae
Findings:
(1) optic nerve head lesion on fundoscopic exam
(2) enhancement of the optic nerve on MRI
(2a) short segment at the optic nerve-globe junction
(2b) short segment enhancement away from optic nerve-globe junction
(2c) long-segment enhancement
A normal MRI does not exclude cat scratch disease related optic neuropathy.
Other conditions that may be concurrent in cat scratch disease:
(1) neuroretinitis
(2) macular hole
(3) encephalopathy
(4) uveitis
(5) retinal vein occlusion
