Branch retinal arterial occlusions in multifocal retinitis with optic nerve edema
S. M. Cohen, J. L. Davis and D. M. Gass
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami (Fla) School of Medicine, USA.
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.
