Related Experiment Video
Updated: Sep 26, 2025
Iris Fixation via External Pentagram Suturing
Published on: May 5, 2022
Choroidal granulomas due to Bartonella henselae infection: A case series
Sarra Gattoussi1,2, Bouchra B Romdhane3, Arnaud Seneclauze1
1Department of Ophthalmology, Bordeaux Hospital, Bordeaux, France.
Insights
Bartonella henselae infection can cause choroidal granulomas, appearing as yellowish lesions on imaging. Positive serology in patients with these lesions suggests this etiology, aiding diagnosis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Medical Imaging
Background:
- Choroidal granulomas are rare and can be caused by various infections or inflammatory conditions.
- Early and accurate diagnosis is crucial for effective treatment and visual preservation.
Observation:
- A case series of three patients diagnosed with choroidal granulomas.
- All patients presented with characteristic lesions on optical coherence tomography (OCT) and angiography.
- Laboratory tests confirmed positive serology for Bartonella henselae in all cases.
Findings:
- Bartonella henselae-induced choroidal granulomas manifest as single or multiple, round, yellowish lesions.
- Multimodal imaging revealed late staining on fluorescein angiography and hypofluorescence on indocyanine green angiography.
- Enhanced depth imaging optical coherence tomography (EDI-OCT) showed hyporeflective lesions with retinal elevation.
Implications:
- This case series highlights Bartonella henselae as an important, often overlooked, cause of choroidal granulomas.
- Ophthalmologists should consider Bartonella henselae in the differential diagnosis of choroidal granulomas, especially with compatible imaging and serology.
- Prompt diagnosis and treatment can prevent vision loss associated with choroidal granulomas.
Purpose:
To report a case series of 3 patients with choroidal granulomas due to Bartonella henselae infection in order to raise awareness about this etiology in the differential diagnosis of choroidal granulomas.
Methods, Patients:
A retrospective case series of patients with choroidal granulomas due to Bartonella henselae infection who consulted between 2018 and 2020. Data were collected from the medical records (demographics, visual acuity (VA), laboratory tests, treatment, imaging).
Results:
Patients were a 48-year old man, a 14-year old girl and a 31-year old man. They all had a choroidal granuloma seen on optical coherence tomography (OCT) and angiography. The laboratory work-up revealed a positive serology for Bartonella henselae in all patients.
Conclusion:
On multimodal imaging choroidal granulomas in B Henselae appeared as single or multiple, uni or bilateral round yellowish lesions. Fluorescein and indocyanine green angiography of the granuloma showed respectively a late staining and a hypofluorescence. On EDI-OCT choroidal granuloma appeared as a round hyporeflective lesion in the choroid with a retinal elevation. The exclusion of other diagnosis, the natural course and the serology must lead the ophthalmologist to evoke the diagnosis.
