Retinal Vascular Changes in Mediterranean Spotted Fever (MSF)

Abstract

Abstract: : Purpose: To study the retinal vascular involvement in patients with MSF, an infectious disease caused by Rickettsia conorii. Methods: Sixty eyes of 30 patients with serologically proven MSF were examined by ophthalmoscopy and fluorescein angiography. Results: Seventeen patients had unilateral (6 patients) or bilateral (11 patients) retinal vascular changes. Findings included focal arterial sheathing (2 eyes, 7.1%); venous sheathing (3 eyes, 10.7%); multiple arterial plaques (1 eye, 3.6%); retinal vascular leakage involving retinal veins (11eyes, 39.3%), retinal arteries (1, 3.6%), both arteries and veins (3, 10.7%), and retinal capillaries (12eyes, 42.6%); branch retinal artery occlusion (1eye, 3.6%); cotton-wool spots (2eyes, 7.1%); optic disc staining (22 eyes, 78.6%);delayed filling in a branch retinal vein (1eye, 3.6%); and retinal neovascularization (1eye, 3.6%). In 10 eyes, (35.7%), vascular involvement was associated with focal or multifocal retinitis. Conclusions: Retinal vasculature is frequently involved in patients with MSF.Fluorescein angiography is particularly helpful in diagnosing and monitoring such retinal vascular changes.Rickettsia conorii infection should be considered in the differential diagnosis of retinal vasculitis and retinal artery and vein occlusions.

Keywords: bacterial disease • imaging methods (CT, FA, ICG, MRI, OCT, RTA, S • inflammation