Right neuroretinitis at first presentation

Cats come under fire for numerous disease transmissions and Te Whatu Ora Southern’s Drs Theo Sutedja and Jerome Languido’s poster reminded us of yet another disadvantage of owning a moggie: cat-scratch disease (CSD), caused by the bacterium Bartonella henselae.

CSD neuroretinitis is a rare ocular manifestation of the disease, occurring in 1 to 2 % of CSD cases and is characterised by optic disc swelling and macular star, the doctors reported.

They described the case of a 19-year-old woman who presented with a one-day history of painless vision-loss in one eye but was otherwise well. She reported having newborn kittens in her home.  Both eyes showed best-corrected visual acuity (BCVA) at 6/120. OCT revealed serous retinal detachment, with hyperaemic and oedematous optic disc, with macula elevation and a spoke-wheel pattern of hard exudates.

Serological testing confirmed elevated Bartonella henselae IgG levels. After six weeks of combined oral rifampicin 300 mg and doxycycline 100 mg, both twice daily, plus three days of intravenous methylprednisolone (10 mg/kg/day) followed by several weeks of oral prednisone at 1 mg/kg/day, the serous retinal detachment resolved and, at two months, BCVA improved to 6/12.