Cat Scratch Fever May Cause Optic Neuroretinitis, Create Vision Changes

Cat scratch fever (CSF) is a common cause of neuroretinitis that can present as vision loss without any other symptoms, according to a poster presented at the 2023 Southeastern Congress of Optometry (SECO) meeting in Atlanta from March 1 to 5. 

Chelsea Brafman, OD, and Sherrol A. Reynolds, OD, of Nova Southeastern University’s school of optometry detailed treatment and management strategies for neuroretinitis resulting from CSF. The condition is caused by Bartonella henselae, a bacteria carried in cat saliva. Patients with CSF present with inflammation of the retina and optic nerve that results in acute unilateral vision loss, optic disc edema, and macular exudates. These symptoms are consistent with infectious neuroretinitis, which is similar to neuroretinitis associated with Lyme disease, toxoplasmosis, syphilis, and tuberculosis.

Data from case reports shows that CSF may  present as vision loss without other symptoms. A comprehensive evaluation and appropriate testing should be performed to determine the cause of vision loss, even if the patient does not report contact with cats. In many cases, an antibiotic is indicated and patients who are highly symptomatic may be candidates for steroid treatment for ocular tissue preservation. CSF frequently resolves with or without treatment.