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One of the unusual manifestations of Cat Scratch Disease is Neuroretinitis (CSD). A fundoscopy revealed macular exudates with a star pattern. Patients who arrive with hazy vision and common fundoscopic abnormalities should be evaluated for CSD.

Macular star exudates, neuroretinitis, and cat scratch disease.

Bartonella henselae is the uncommon infection that causes cat scratch disease (CSD). An unusual manifestation of CSD is neuroretinitis [1]. A 33-year-old woman who saw her primary care doctor with left jaw pain and edoema was treated for what might have been a dental infection. She was sent to the ophthalmologist after experiencing photophobia and impaired vision in the left eye throughout the course of the following several days. She acknowledged exposure to domestic cats while working in a public park. Upon inspection,it Her extraocular movements were unhampered, and her pupils responded to light swiftly and equally. The right eye test was clear. Vision in the left eye was 20/50. On fundoscopy, she had a minor loss in the strength of her left colour vision, disc edoema, and characteristic mac-ular exudates arranged in a star pattern. IgM antibody titers of 1:1024 were used to validate the diagnosis of CSD. She received treatment for six weeks with rifampin and doxycycline [2]. Her visual acuity increased and the intensity of her colour vision returned to normal after three weeks of therapy. At three months, all symptoms, fundoscopic abnormalities, and antibody titers had disappeared completely.

1. Cunningham, E. T., and J. E. Koehler. 2000. Ocularbartonellosis. Am. J. Ophthalmol. 130:340–349.

2. Rolain, J. M., P. Brouqui, J. E. Koehler, C. Maguina, M. J.Dolan, and D. Raoult. 2004. Recommendations fortreatment of human infections caused byBartonellaspecies.Antimicrob. Agents Chemother. 48:1921–1933.

Jagadeesh K. Kalavakunta. Cat scratch neuroretinitis: a star in the eye. Insights of Clinical and Medical Images 2022.