Cat-scratch disease: unusual perivascular chorioretinal lesions

Area of Science:

• Ophthalmology
• Infectious Diseases
• Veterinary Medicine

Background:

• Cat-scratch disease, caused by Bartonella henselae, is a common zoonotic infection.
• Ocular manifestations of cat-scratch disease are varied but typically involve neuroretinitis or uveitis.

Observation:

• A 37-year-old woman presented with a five-year history of intermittent blurred vision and headache.
• Funduscopic examination revealed bilateral yellow-brown pigmented perivenous chorioretinal lesions along the superotemporal and inferotemporal vascular arcades.
• Associated findings included vascular fibrous bands and changes in vascular caliber, with no intraocular inflammation.

Findings:

• Serologic tests confirmed Bartonella henselae infection, diagnosing cat-scratch disease.
• The patient's ocular lesions showed no progression or associated inflammation during a three-year follow-up period.
• No specific treatment was administered for the ocular findings.

Implications:

• This case highlights a rare presentation of Bartonella henselae infection manifesting as bilateral perivascular chorioretinal lesions.
• The findings suggest that some ocular manifestations of cat-scratch disease may be self-limiting and resolve without intervention.
• Further research is warranted to understand the natural history and management of such ocular presentations of CSD.