Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection - 05/09/11

Doi : 10.1016/S0002-9394(00)00599-7

N.Kevin Wade ^a,^b : MDCM, FRCPC, FRCSC, Leah Levi, MBBS ^c, Matthew R Jones, MD ^b, Robert Bhisitkul, MD, PhD ^a, Laura Fine, MD ^a, Emmett T Cunningham, MD, PhD, MPH ^a,^b,⁎
^a Francis I. Proctor Foundation (Drs Wade, Fine, and Cunningham), San Francisco, California, USA
^b Department of Ophthalmology, University of California, San Francisco, Medical Center (Drs Wade, Jones, Bhisitkul, Fine, and Cunningham), San Francisco, California, USA
^c Departments of Ophthalmology and Neurosciences, University of California, San Diego (Dr Levi), La Jolla, California, USA

^*Requests for reprints to Emmett T. Cunningham, Jr., The Pearl & Samuel J. Kimura Ocular Immunology Laboratory, The Francis I. Proctor Foundation, University of California, San Francisco, Medical Center, San Francisco, California 94143-0944; fax: (415) 476-0527

Abstract

PURPOSE: To describe optic disk edema associated with peripapillary serous retinal detachment as an early sign of systemic Bartonella henselae infection.

METHODS: Multicentered, retrospective case series.

RESULTS: Five women and two men presented with optic disk edema producing peripapillary serous retinal detachment. Each patient had a markedly elevated serum anti–B. henselae antibody titer. Patient age ranged from 11 to 44 years, with a mean and median of 26.6 and 28 years, respectively. The time from the onset of systemic symptoms to the onset of visual symptoms varied from 3 days to 1 month. The peripapillary serous retinal detachment resolved within 1 to 3 weeks in each case, producing a macular star in four of seven patients. Initial vision was 20/200 or worse in five of seven patients and improved in four of these five patients to 20/30 or better.

CONCLUSIONS: Systemic B. henselae infection should be considered in patients who develop optic disk edema associated with a peripapillary serous retinal detachment, even in the absence of classic neuroretinitis with a macular star.

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This work was supported in part by a grant from the Canadian National Institute for the Blind and the E.A. Baker Foundation Fellowship Award (Dr Wade), and a Career Development Award from Research to Prevent Blindness, Inc, New York, New York (Dr Cunningham).

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Vol 130 - N° 3

P. 327-334 - septembre 2000 Retour au numéro

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Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection - 05/09/11

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