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A. Hirayama, Y. Chai, H. Yamazaki, J. Yotsukura, S. Yamamoto; Pattern Visual Evoked Potentials in Eyes With Disc Swelling Due to Cat–Scratch Disease . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5675.
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Purpose: To evaluate optic nerve function by pattern visual evoked potentials (VEPs) in eyes with disc swelling associated with cat–scratch disease. Methods: Four eyes of 4 patients with marked optic disc swelling resembling optic neuritis but diagnosed serologically as cat–scratch disease received systemic steroid treatment. VEPs elicited by black and white checkerboard stimuli that appeared on a TV monitor were recorded before the treatment. Results: Visual acuity (VA) in the affected eyes was decreased to 20/50 in 2 patients and finger counting in 2 patients at their initial visits. Ophthalmoscopic examination revealed neuroretinitis characterized by severe optic disc swelling, chorioretinal exudative lesions, and macular edema in all eyes. Anti–Bartonella henselae serum antibody was markedly elevated in all patients, confirming the diagnosis of cat–scratch disease. The P100 of the pattern VEPs were only mildly reduced without a delay in all eyes before treatment. The VA fully recovered after systemic steroid treatment in all patients. Conclusions: Although all examined patients showed marked swelling of optic disc and visual loss, pattern VEPs were only mildly affected, indicating that optic nerve function was not as impaired as in idiopathic optic neuritis. From these results, we recommend that pattern VEPs be used to assess optic nerve function in eyes with swollen optic discs for the differential diagnosis from idiopathic optic neuritis when serological test results cannot be immediately obtained.
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