June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Expanding the Spectrum of Bartonella-Associated Neuroretinitis
Author Affiliations & Notes
  • Jorge Orellana-Rios
    Fundación Oftalmológica Los Andes, Santiago de Chile, Chile
  • Belinda Leong
    Retina Associates of Sydney, Sydney, New South Wales, Australia
  • Juan I Verdaguer-Diaz
    Fundación Oftalmológica Los Andes, Santiago de Chile, Chile
  • K Bailey Freund
    Vitreous Retina Macula Consultants of New York, New York, New York, United States
  • Footnotes
    Commercial Relationships   Jorge Orellana-Rios, None; Belinda Leong, None; Juan Verdaguer-Diaz, None; K Bailey Freund, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5369. doi:
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      Jorge Orellana-Rios, Belinda Leong, Juan I Verdaguer-Diaz, K Bailey Freund; Expanding the Spectrum of Bartonella-Associated Neuroretinitis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5369.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To describe the occurrence of Bartonella-associated neuroretinitis secondary to non-feline pet exposure.

Methods : Medical records and imaging from 2 patients with confirmed Bartonella henselae (BH) neuroretinitis were retrospectively reviewed. Retinal imaging included color fundus photographs, optical coherence tomography (OCT), and fluorescein angiography (FA).

Results : A 51-year-old woman presented with a central scotoma and decreased vision in her right eye (RE) for several days. She reported the onset of headache, malaise and inguinal lymphadenopathy 5 days after being scratched by her pet ferret (Mustela putorius furo). Clinical examination revealed disc edema and a macular star in the RE with subretinal fluid present on OCT B-scans. Best-corrected visual acuity (BCVA) was 20/30 in RE and 20/25 in the left eye (LE). Focal retinitis with overlying vitreous cells were present along retinal arcades in both eyes. Serology was positive for anti-BH (IgM titers 1:10, IgG titers 1:512). Following 6-weeks of oral Azithromycin 500 mg/daily, visual acuity improved to 20/20 in both eyes.
A 19-year-old man reported 3 weeks of decreased of vision and central scotoma in his LE. Fever and preauricular lymphadenopathy were noted 1 week after manipulation of a pet guinea pig (Cavia porcellus). At presentation, BCVA in the RE was 20/20 and 20/200 in affected LE. Late disc leakage in the LE was identified on FA. Color fundus photographs of the LE showed a focal area of retinitis along the distal inferotemporal retinal arcade. Serology included high-titer anti-BH antibodies (IgG titers 1:1024). Complete resolution of disease was noted after 8-weeks of oral Doxycycline 200 mg/daily plus Rifampicin 600 mg/daily.

Conclusions : Humans may develop cat-scratch disease when they are exposed to BH in the saliva of infected cats or BH-containing flea feces reaching the systemic circulation through scratches or mucous membranes. As the cat flea (Ctenocephalides felis) may reside on non-feline animals, Bartonella-associated neuroretinitis may result from contact with other furred family pets.

This is a 2020 ARVO Annual Meeting abstract.


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