American Journal of Ophthalmology
Volume 130, Issue 3 , Pages 327-334, September 2000

Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection☆

  • N.Kevin Wade (MDCM, FRCPC, FRCSC)

      Affiliations

    • Francis I. Proctor Foundation (Drs Wade, Fine, and Cunningham), San Francisco, California, USA
    • Department of Ophthalmology, University of California, San Francisco, Medical Center (Drs Wade, Jones, Bhisitkul, Fine, and Cunningham), San Francisco, California, USA
    • ,
  • Leah Levi, MBBS

      Affiliations

    • Departments of Ophthalmology and Neurosciences, University of California, San Diego (Dr Levi), La Jolla, California, USA
    • ,
  • Matthew R Jones, MD

      Affiliations

    • Department of Ophthalmology, University of California, San Francisco, Medical Center (Drs Wade, Jones, Bhisitkul, Fine, and Cunningham), San Francisco, California, USA
    • ,
  • Robert Bhisitkul, MD, PhD

      Affiliations

    • Francis I. Proctor Foundation (Drs Wade, Fine, and Cunningham), San Francisco, California, USA
    • ,
  • Laura Fine, MD

      Affiliations

    • Francis I. Proctor Foundation (Drs Wade, Fine, and Cunningham), San Francisco, California, USA
    • ,
  • Emmett T Cunningham Jr., MD, PhD, MPH

      Affiliations

    • Francis I. Proctor Foundation (Drs Wade, Fine, and Cunningham), San Francisco, California, USA
    • Department of Ophthalmology, University of California, San Francisco, Medical Center (Drs Wade, Jones, Bhisitkul, Fine, and Cunningham), San Francisco, California, USA
    • Corresponding Author InformationRequests for reprints to Emmett T. Cunningham, Jr., The Pearl & Samuel J. Kimura Ocular Immunology Laboratory, The Francis I. Proctor Foundation, University of California, San Francisco, Medical Center, San Francisco, California 94143-0944; fax: (415) 476-0527

Accepted 6 June 2000.

Abstract 

PURPOSE: To describe optic disk edema associated with peripapillary serous retinal detachment as an early sign of systemic Bartonella henselae infection.

METHODS: Multicentered, retrospective case series.

RESULTS: Five women and two men presented with optic disk edema producing peripapillary serous retinal detachment. Each patient had a markedly elevated serum anti–B. henselae antibody titer. Patient age ranged from 11 to 44 years, with a mean and median of 26.6 and 28 years, respectively. The time from the onset of systemic symptoms to the onset of visual symptoms varied from 3 days to 1 month. The peripapillary serous retinal detachment resolved within 1 to 3 weeks in each case, producing a macular star in four of seven patients. Initial vision was 20/200 or worse in five of seven patients and improved in four of these five patients to 20/30 or better.

CONCLUSIONS: Systemic B. henselae infection should be considered in patients who develop optic disk edema associated with a peripapillary serous retinal detachment, even in the absence of classic neuroretinitis with a macular star.

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

☆ This work was supported in part by a grant from the Canadian National Institute for the Blind and the E.A. Baker Foundation Fellowship Award (Dr Wade), and a Career Development Award from Research to Prevent Blindness, Inc, New York, New York (Dr Cunningham).

PII: S0002-9394(00)00599-7

American Journal of Ophthalmology
Volume 130, Issue 3 , Pages 327-334, September 2000

Article Tools

* Image Usage & Resolution