Tolou C, Mahieu L, Martin-Blondel G, Ollé P, Matonti F, Hamid S, Benouaich X, Debard A, Cassagne M, Soler V
Unité de rétine, consultation d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse cedex, France.
Service de maladies infectieuses et tropicales, CHU de Toulouse, 31059 Toulouse, France; Inserm U1043, CNRS UMR 5282, centre de physiopathologie de Toulouse-Purpan, 31059 Toulouse, France; Université Toulouse III, 31000 Toulouse, France.
J Fr Ophtalmol. 2015 Dec;38(10):974-82. doi: 10.1016/j.jfo.2015.07.003. Epub 2015 Nov 3.
Cat-scratch disease (CSD) is a systemic infectious disease. The most well-known posterior segment presentation is neuroretinitis with a macular star. In this study, we present a case series emphasising the heterogeneity of the disease and the various posterior segment manifestations.
A retrospective case series of consecutive patients presenting with posterior segment CSD, over a 5-year period (2010 to 2015), at two ophthalmological centres in Midi-Pyrénées.
Twelve patients (17 eyes) were included, of whom 11 (92%) presented with rapidly decreasing visual acuity, with 6 of these (50%) extremely abrupt. CSD was bilateral in 5 (42% of all patients). Posterior manifestations were: 12 instances of optic nerve edema (100%), 8 of focal chorioretinitis (67%) and only 6 of the classic macular edema with macular star (25% at first examination, but 50% later). Other ophthalmological complications developed in three patients; one developed acute anterior ischemic optic neuropathy, one a retrohyaloid hemorrhage and one a branch retinal artery occlusion, all secondary to occlusive focal vasculitis adjacent to focal chorioretinitis.
Classical neuroretinitis with macular star is not the only clinical presentation of CSD. Practitioners should screen for Bartonella henselae in all patients with papillitis or focal chorioretinitis.
猫抓病（CSD）是一种全身性感染性疾病。最广为人知的后段表现是伴有黄斑星芒的视神经视网膜炎。在本研究中，我们展示了一个病例系列，强调了该疾病的异质性以及各种后段表现。
这是一个回顾性病例系列，研究对象为2010年至2015年期间在南比利牛斯的两个眼科中心连续就诊的患有后段CSD的患者。
纳入了12例患者（17只眼），其中11例（92%）视力迅速下降，其中6例（50%）下降极为突然。5例（占所有患者的42%）CSD为双侧性。后段表现为：12例视神经水肿（100%），8例局灶性脉络膜视网膜炎（67%），而典型的伴有黄斑星芒的黄斑水肿仅6例（初诊时为25%，但后来为50%）。3例患者出现了其他眼科并发症；1例发生急性前部缺血性视神经病变，1例发生玻璃体后出血，1例发生视网膜分支动脉阻塞，均继发于局灶性脉络膜视网膜炎附近的闭塞性局灶性血管炎。
伴有黄斑星芒的典型视神经视网膜炎并非CSD的唯一临床表现。从业者应对所有患有视乳头炎或局灶性脉络膜视网膜炎的患者筛查汉赛巴尔通体。
