Premium
Cat‐scratch disease: ocular manifestations and treatment outcome
Author(s) -
HabotWilner Zohar,
Trivizki Omer,
Goldstein Michaella,
Kesler Anat,
Shulman Shiri,
Horowitz Josepha,
Amer Radgonde,
David Ran,
BenArieWeintrob Yael,
Bakshi Erez,
Almog Yehoshua,
Sartani Gil,
VishnevskiaDai Vicktoria,
Kramer Michal,
Bar Asaf,
Kehat Rinat,
Ephros Moshe,
Giladi Michael
Publication year - 2018
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13684
Subject(s) - medicine , optic nerve , visual acuity , lesion , odds ratio , ophthalmology , retrospective cohort study , optic neuropathy , uveitis , medical record , cohort , optic disc , surgery , retinal
Purpose To characterize cat‐scratch disease ( CSD ) ocular manifestations and visual outcome and evaluate the effect of systemic antibiotics and corticosteroids on final visual acuity ( VA ). Methods Multicentre retrospective cohort study. Medical records of 86 patients with ocular disease (107 eyes) of 3222 patients identified in a national CSD surveillance study were reviewed. Results Mean age was 35.1 ± 14.2 years. Median follow‐up was 20 weeks (range 1–806 weeks). Of 94/107 (88%) eyes with swollen disc, 60 (64%) had neuroretinitis at presentation, 14 (15%) developed neuroretinitis during follow‐up, and 20 (21%) were diagnosed with inflammatory disc oedema. Optic nerve head lesion, uveitis, optic neuropathy and retinal vessel occlusion were found in 43 (40%), 38 (36%), 34 (33%) and 8 (7%) eyes, respectively. Good VA (better than 20/40), moderate vision loss (20/40–20/200) and severe vision loss (worse than 20/200) were found in 26/79 (33%), 35/79 (44%) and 18/79 (23%) eyes at baseline and in 63/79 (80%), 11/79 (14%) and 5/79 (6%) eyes at final follow‐up, respectively (p < 0.001). Significant VA improvement (defined as improvement of ≥3 Snellen lines at final follow‐up compared to baseline) occurred in 12/24 (50%) eyes treated with antibiotics compared with 14/16 (88%) eyes treated with antibiotics and corticosteroids (p = 0.02). Multivariate logistic regression was suggestive of the same association (odds ratio 7.0; 95% CI 1.3–37.7; p = 0.024). Conclusion Optic nerve head lesion is a common and unique manifestation of ocular CSD . Most patients improved and had final good VA . Combined antibiotics and corticosteroid treatment was associated with a better visual outcome.