A patient with cat scratch disease may develop an optic neuropathy.

Patient selection: infection with Bartonella henselae



(1) reduced visual acuity in one or both eyes

(2) history of a cat or kitten scratch

(3) positive serology for Bartonella henselae



(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

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