Medical Subject Headings
Cat-scratch Disease; Papilledema; Mumps; Optic Disk Drusen, Retinitis
Background: Neuroretinitis is an inflammation of the posterior pole of the eye, resulting in optic disc edema and macular star formation. Systemic conditions associated with these findings include tuberculosis, toxoplasmosis, syphilis, lyme disease, toxocariasis, mumps, herpes simplex, and cat scratch disease. This case illustrates diagnosis and treatment for a patient with neuroretinitis complicated by preexisting vision loss.
Case Report: A Caucasian male in his 40’s presented to the eye clinic for an emergency appointment with complaints of constant blurry vision, especially inferiorly upon awakening, in his right eye for the past two weeks. His ocular history included optic disc drusen in both eyes with profound peripheral vision loss in the left eye. The patient’s systemic history included cluster headaches and sleep apnea. Entering visual acuities were 20/150- OD and 20/20 OS. Additional medical history questioning revealed the recent adoption of a kitten.
Conclusion: This case describes the diagnosis and treatment for the rare condition of neuroretinitis secondary to a Toxocara infection. While cat scratch disease was initially suspected, detailed laboratory testing identified the true, and more rare, causative infectious agent. A variety of differential diagnoses were ruled out through laboratory and imaging studies. Consultations with neuro-ophthalmology and infectious disease specialists were exceedingly valuable in contributing to a positive outcome for this patient. This patient’s preexisting ODD with vision loss heightened the concern to preserve the patient’s remaining vision and further added to the complexity of this challenging case. The importance of medical history questions regarding animal contact also proved vital for accurate diagnosis and treatment of this sight threatening condition.
Kreinbrink J, Weibel A, Weibel K. Bilateral Optic Disc Drusen with Neuroretinitis. Optometric Clinical Practice. 2022; 4(2):5. doi:10.37685/uiwlibraries.2575-77126.96.36.1990. https://doi.org/10.37685/uiwlibraries.2575-77188.8.131.520
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