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  Vol. 113 No. 10, October 1995 TABLE OF CONTENTS
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Branch Retinal Arterial Occlusions in Multifocal Retinitis With Optic Nerve Edema

Steven M. Cohen, MD; Janet L. Davis, MD; J. Donald M. Gass, MD

Arch Ophthalmol. 1995;113(10):1271-1276.


Abstract



Objective
To determine the natural history and visual prognosis of patients with branch retinal arterial occlusions secondary to multifocal retinitis.

Methods
Cases were reviewed for seven patients who exhibited multifocal retinitis and branch retinal arterial occlusion. The average age of the patients was 27 years (age range, 14 to 19 years).

Results
Six patients had systemic illnesses associated with their ocular findings. Four patients were scratched by a cat or exposed to a cat with fleas within 1 month of symptoms. Three of these patients were tested and had positive cat-scratch disease titers. At presentation, five patients complained of a scotoma, and two noted blurred vision. On examination, visual acuity was 20/25 or better in all but one eye. Five patients had vitritis, which was bilateral in three. Four patients exhibited optic nerve edema, which was bilateral in two. White intraretinal infiltrates were present in all patients, and were bilateral in five. The six patients who were examined within 1 week of symptoms had a white retinal infiltrate at the site of vascular occlusion. The retinal findings resolved in 2 to 6 weeks and did not recur. The final visual acuity was 20/20 OU in all patients.

Conclusions
Branch retinal arterial occlusions represent a complication of multifocal retinitis and idiopathic optic nerve edema. The arterial occlusions are probably caused by a focus of retinitis. This self-limited disorder has an excellent visual prognosis and may be related to cat-scratch disease.



Author Affiliations



From the Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami (Fla) School of Medicine. Dr Cohen is now affilated with Retina Associates of Florida, PA, Clearwater.



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